


Where The Streets Have No Name

by J_Baillier



Series: You Go To My Head [12]
Category: Sherlock (TV), Sherlock Holmes & Related Fandoms
Genre: Adventure, Africa, Angst, Autism Spectrum, Awkward First Times, Career crisis, Dengue fever, Depression, Garridebs moment, Global inequality in healthcare, Hiking, Holidays, Hurt/Comfort, Idiots in Love, Internalised ableism, John Whump, M/M, Malawi, Medical H&C, Medical husbands, Medicine, Romance, Self Confidence Issues, Sex Dreams, Sherlock loves animals, Some upsetting and suspenseful medical content, Surgery, Weddings, anaesthesiologist!John, neurosurgeon!Sherlock
Language: English
Status: Completed
Published: 2018-11-19
Updated: 2018-12-16
Packaged: 2019-08-26 01:45:50
Rating: Explicit
Warnings: No Archive Warnings Apply
Chapters: 11
Words: 54,900
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/16672432
Author URL: https://archiveofourown.org/users/J_Baillier/pseuds/J_Baillier
Summary: A work motivation crisis, a wedding, and a crazy plan (which turns out to be not so crazy after all) lead doctors Holmes and Watson to Africa.





	1. Guiding Light

**Author's Note:**

> I have not had the privilege of working in developing countries, but have listened to the stories of many colleagues with such experiences. Malawian healthcare on a grassroots level turned out to be quite a challenge to research, and I worried greatly about avoiding stereotypes, wanting, most of all, to illustrate the astonishing imagination, dedication, and adaptability of healthcare workers when it comes to making do with very little. Plenty of artistic license has been employed in this story—more than in other parts of the series—and certain things may well be better in the country as depicted here, or worse. The real hospital in Malosa is called St Luke's; I chose to create a fictional version to make sure I could employ as much of the aforementioned artistic licence as I needed. The title of the story is borrowed from a U2 song which is said to be inspired by the lead singer's experiences of charity work in Africa.

  
  


Moths are dancing in the warm, yellow light of a storm lantern hanging from an overhanging branch of a fever pod tree— _kachamira_ , the locals call the impressive species. A distant rumble of thunder sounds from the mountains in the distance—a harbinger of an imminent storm that has already cut power in the area.

His rattan chair creaks when John leans forward to reach for his mug of tea. He downs the last of it, then stands up to stretch his back. The first drops of rain are falling, so he wanders back inside the house, grabbing another lantern from the dining table since it's already dark inside; the sun is going down behind the thickening cloud cover. As he heads down the hallway, the dancing shapes the lantern light paints on the walls look like shadow puppet theatre.

He finds Sherlock in a small study in the back of the house. An old oil lamp burns on the desk, next to which Sherlock has arranged no less than three old medical textbooks. With the internet connection down, they are all he has at his disposal to prepare for tomorrow's work. John is used to the sight of him spending long evenings studying; there is much in surgery his husband has never learned or has not done for many years. Now, any of those missing morsels of knowledge might be something he needs to save someone's life or limb. Thankfully, he's a fast learner with an eidetic memory and a formidable knowledge base of human anatomy and surgical technique.

In the Western world, Sherlock would have to worry about litigation if he took on an operation he has never attempted before and which he is teaching himself on the go. In Britain, medical improvisation and thinking outside the box would most likely be rewarded with suspicion and condemnation from management. But, out here, anything and everything he attempts is more likely to be met with gratitude and hope.

Sherlock's nose is scrunched up to accompany a thoughtful frown as his fingers skim the text in front of him. John wraps his arms around the shoulders of his husband of four months and presses a kiss into the slightly sweaty curls. The one thing they both miss the most from London is air conditioning. Apart from that, most of the time John feels like he has everything he needs.

Sherlock acknowledges his newly arrived company with a distracted hum and a touch of his fingertips to the arm on his chest.

"Come to bed," John suggests quietly, reaching down to turn off the lantern he'd placed on the floor.

"I still haven't worked out how to construct an approximation of a tibial plate from the ankle fracture sets Joseph found at the back of the closet. That's all we have right now, and the plate needs to be suitable for a patient whose bones are still growing."

Despite the enormous challenges he faces here, Sherlock doesn't sound as stressed as he often has when facing a difficult case at King's College Hospital. Here, his scientific curiosity seems to have reawakened, and he treats all problems as puzzles to be solved, instead of live grenades full of potential for disastrous social faux pas and endless bad consequences in the form of bureaucrats demanding reports.

The price to pay for this newfound autonomy is having to work in very primitive conditions. King's College has clean and consistently running water, storage rooms filled to the brim with endless packets of sterile sutures and proper laparotomy instruments safely sterilised, and plenty of trained staff. Here, at Malosa District Hospital, they have none of those things, but they make do.

Last month, Sherlock had diagnosed an acute brain bleed in trauma patient from a car accident without any brain imaging at his disposal. He had spotted a Cushing's triad of uneven breathing, bradycardia and high systolic blood pressure, combined with abnormal pupil size and reactivity. They'd rushed the patient into the hospital's only OR only to be told there was no cranial drill available. Unfazed, Sherlock had ordered his assistant promptly to fetch the village carpenter to borrow his gear. The patient had emerged from anaesthesia alive and only slightly confounded after her acute traumatic subdural hematoma had been successfully drained. A week after she had been discharged, her husband had gifted a baffled Sherlock with the only goat they owned. He'd tried to decline but Louise, their Malosan housekeeper and cook, had informed him that he'd gravely insult the poor man if he wouldn't accept the gift. The resourceful Louise, who has been indispensable to how well they have settled in, had then solved the issue by gifting the goat back to the family three days later by saying it was a donation from the hospital.

John had grown quite fond of the goat during those three days it had spent tied to a tree in the front yard even though it had eaten half of John's favourite T-shirt. Sherlock had named it Anderson ' _since he bleats as much_ '.

"Did they tell you that the autoclave's finally fixed?" John asks him, referring to a machine which sterilises surgical equipment with high-pressure water steam. He starts kneading his thumb tips into the tightly knotted muscles on the back of Sherlock's neck, which brings forth a sigh and a shudder.

"A fat lot of good that will do if the electricity doesn't come back on. I don't trust the spare generator further than I could throw it." Sherlock sticks his fingertips into his messy curls and gives them a shake. "Did you speak to the Minister about assigning an officer to curate the distribution of supplies to regional hospitals?"

"His secretary says he'll take my call tomorrow."

The entire country of Malawi has long suffered from an inefficiently run public healthcare system where tertiary hospitals get the first pick of supplies, and very little of them trickle down to secondary district hospitals and rural clinics. After years of being head of operating room logistics at King's, John hasn't hesitated to try to influence the powers-that-be to fix the most glaring issues. Jens-Erik and Åse, the Norwegian married doctor couple with whom they form the hospital's tiny pool of doctors, have told him they've been trying to change the same things for years, to no avail.

Palms resting on his partner's shoulders, John leans further over them to better see the images on the pages of the well-underlined textbook Sherlock is consulting. Colleagues from King's had sent boxfuls of their old ones over after they'd sent an email request requesting them. The internet here is, at best, fickle to function, so it's hard to check things online.

"You really enjoy learning things on the run, don't you?" John points out.

Sherlock twists his torso to look at him. "It still surprises you." He sounds mildly dismayed.

John grabs the edge of the cover to glimpse the title of the book—an old edition of _Wessel's_ _Operative Techniques in Trauma Surgery_. "I guess it does. Mostly, I'm relieved. Wouldn't have wanted you to be stuck here for eight months, hating every moment."

"I did do my research before deciding."

"I know, love."

Who would have known that Sherlock, of all people, would be such a good match for rural healthcare in a developing country? He has embarrassed John so many times already by breezing through situations and challenges which John would have assumed would be much more difficult for him. Then again, there have been many things Sherlock has found difficult which have not bothered John at all, things he hadn't even realised could be challenging to someone. After all these years, when it comes to understanding Sherlock, he still often feels like a beginner. Through the years, there have been so many things Sherlock has learned, managed, and overcome against the assumptions of others. Those lessons have been hard-won, but they have been very, very necessary for the survival of their relationship.

And, not just survival—for its recent _thriving_.

But, how did they get here? How did they end up in rural Malawi, after spending years living a hectic life and building high-powered careers in London?  
  
  


 


	2. Disillusionment

**Notes for the Chapter:**

> Chapter betaed by 7PercentSolution.

_As if it weren't bad enough to fall, the ladder lands on top of you._  
—Malawian proverb

 

——TEN MONTHS EARLIER——

Sherlock snaps his back straight, raises his bow and launches into the first notes of Sarasate's _Zigeunerweisen_. He gives it the gravitas it needs, leaning the bow into the strings so hard that a cloud of rosin is puffing off the horsehairs, sprinkling into the lacquered surface of the violin underneath like falling snow. While the faster passages of the composition serve well to channel his frustrations, he's hardly in the mood for treating right the prolonged legatos and the wailing crescendos. He is also sorely lacking the patience required by some of the mellower themes in the piece. According to the composer's instructions written on the sheet music, the beginning should be _espressivo—_ expressive, and the quick gliding scale that follows must be played downright _brillante_. Sherlock can easily conquer the expressive section but right now, after the day he's had, he hardly feels brilliant.

What he feels like is a performing monkey, a side-lined nuisance. That's how they'd all been looking at him this morning.

"Furthermore," the chairman of the board had read at him, straight from a piece of paper instead of addressing him like a human being—like a surgeon. The grey-haired old fool glanced at Sherlock warily as though expecting him to throw a tantrum, before continuing: "The Board sees no justification to alter the well-established Trust guidelines regarding experimental treatment on individual patients. If anything, the Board feels that a different decision would set a dangerous precedent to allow one consultant's discretion to determine the parameters within which their patients are to be treated in a manner too autonomous to be safe."

It had all been a cop-out, cowards hiding behind words and stripping him of the autonomy a doctor—any doctor—should have, instead of having to bow to idiots from business schools. The Board isn't going to be hung from the rafters if someone’s treatment proves harmful or unethical—it's the doctor who's under fire. And, though Sherlock had been willing to carry that responsibility, they wouldn't let him.

He had made the application to the Trust's Ethical Advisory Council to order in a recently patented, swivelled shunt for a patient whose prior intracranial injuries and a complex aneurysm treated before with surgical clipping created a need to route a shunt through a convoluted path. Without one, she'll gradually turn into a vegetable or die of an infection as the cerebrospinal fluid accumulating inside her skull either needs to be drained through the spine—exposing her central nervous system to bacteria—or by displacing brain tissue unless there is no space left for it. The shunt he would have used is already being commercially produced in China, but no Western country has yet approved it for use. This is what had distressed the Ethics Council enough to deny his request and condemn the patient. Sherlock had escalated the issue by making a detailed appeal to overturn the decision.

As they all filed out of the conference room, Sherlock's morning had been glazed with even more frustration when he'd come face to face with Philip Anderson.

"What a waste of bloody time," Anderson muttered upon seeing him. The man had been called in to give his expert opinion on potential treatment options for the patient since apparently, Sherlock's opinion wasn't good enough even though they are the same speciality and rank. Sherlock is still angry at their boss, Lestrade, for refusing to take sides and leaving the matter to the Board to decide.

 _Cowards_. _For them, patients are just expenses, risks to be mitigated, slots on a spreadsheet._  

As they stood waiting for the lift, Anderson couldn’t resist crowing, "You should leave ethics to the grown-ups, Holmes. Can't save everyone, especially if you mostly just fancied a go with a new toy."

Sherlock had practically growled at the man, causing Lestrade to grip his shoulder and steer him towards the stairs since the lift hadn't arrived yet. _As though I needed to be put on a time-out._ _As though I'm not sensible enough to decide that The Botch's inane opinions aren't worth listening to_.

"Don't mind him," Lestrade told him for emphasis as they descended the steps.

He gritted his teeth, memories of such statements from days past floating to the surface.

_'Turn the other cheek, Sherlock', 'The other boys are just envious of you, Sherlock', 'Rules apply to everyone, young man!', Don't stoop to their level, Sherlock', 'Can't you just behave for a change instead of insulting your schoolmates, Sherlock', 'You can't always get what you want, dear, the world doesn't work that way'._

"I'm the one who has to convey _their_ decision to the patient," Sherlock snapped to his boss. He then hurried past Lestrade down the stairs, not stopping until he was on the ground floor. He must have been already expected in surgery, but a cigarette to calm his nerves was, at that moment, not an indulgence but a necessity.

In the OR, he worked on autopilot, thoughts still firmly stuck on longing for vengeance and seething in anger. _Who does this system benefit? Who is it built for? If a physician and a patient agree on a plan, who are these suited idiots to tell them otherwise?_

Christine Brecker, _his patient_ , was going to lose all her abilities and die because of rules and regulations and bureaucratic idiocy trying to prevent surgeons from doing their jobs. It's not his fault, and his rational mind knows it, but it doesn't feel like it when he has to face Christine and her family and deliver the crushing blow.

 _Perhaps I should buy her a plane ticket to China to have the shunt installed there_ , he thought bitterly. _Though I'm sure the Board would find some way to punish me for that, too_.

In the afternoon, after his straightforward meningioma removal was done, he made his way to the neurosurgical ward to have the conversation. He kept his final encounter with the Brecker family short and to the point. There were no words he could have offered in consolation, so he refrained from even trying. He hadn't asked John or Marie from his outpatient clinic along like he usually does when he needs to discuss something delicate; today, the notion of needing a chaperone to cushion his interactions with others had not felt reassuring – it had felt so condescending that it had made his blood boil. Undoubtedly he has become at least passable in using platitudes to calm people down. 

The Breckers thank him for trying.Even that feels embarrassing and undeserved. Through accepting his paycheck each month, he is part of the system, even when he tries to buck against it. The NHS wants his surgical skills, that's all. Everything else about him is something the Trust would prefer to change, to mould to their liking. _House-trained. Docile. Easy. Amicable._

He stops playing to apply more rosin to his bow.

As John might phrase it, it's been a crappy month altogether. Besides having to deal with the experimental treatment debacle, there was another issue plaguing nearly all physicians in Britain in this day and age which affected his work, stealing precious time from his patients: litigation.

A neurosurgeon from another London teaching hospital had been sued by the family of a patient who had died three months after the partial resection of a glioblastoma multiforme. It is a grade 4 malignancy—the worst kind. Even if all visible cancerous tissue is removed, a surgeon can be certain that the disease still lurks in the brain like the invisible tendrils of a Portuguese man-o-war, to which Sherlock had sometimes compared it to in his lectures. The patient had died a month after the operation when the growing tumour had broken through a blood vessel, and the family was convinced that the death was due to a mistake made in the operation—as though one could somehow protect blood vessels from being affected when a highly malignant tumour keeps spreading. At some point, the family had been contacted by an unscrupulous lawyer who practically pushed them into seeking astronomical compensation for a mistake that was never even made. Since Sherlock is one of London's leading posterior fossa surgeons, he was asked by the defence to act as an expert witness. After talking to the surgeon and reviewing the records and the imaging results, his assessment was that he could not find any fault in the management of the case. Personally, he might have tried to get even more of the tumour out, but that just went to show how cautious and conscientious the defendant had been. He was happy to appear in court—he wasn't going to let a perfectly competent colleague get strung up in the gallows.

John had been worried about his appearance, saying that he should refrain from, quote: _'smart-arse remarks and generally being yourself_ '. Sherlock had slammed his locker shut and walked out of the dressing room without a word after that.

"Sometimes, we can't cheat death. Sometimes, our patients die, especially if they have an untreatable, highly malignant brain tumour. A bleed a month after a perfectly successful and by-the-book decompressive, non-curative craniotomy is simply the disease progressing, not a complication. The mortality of humanity is a hundred per cent, and our individual life-long risk of death is the same," he had icily told the barrister of the opposite side in court.

The man had jogged through the medical issues and then focused on trying to destroy Sherlock's credibility by dragging out things from his past. All of those things were available through public records—if one knew who to ask and where to look—but the experiment had not been pleasant. Those things had nothing to do with the issue of why they were in that courtroom. Eventually, he had grown tired of the barrister's personal attacks and general incompetence and made a few select remarks regarding the validity of the case and the professionalism of the man. Perhaps he had also said something about the judicial system's approach to medical issues in general, and, as a result, the judge had threatened him with a trip to a holding cell for being in contempt of the court. Thankfully, the prosecutor had refrained from further questioning, sparing Sherlock from the temptation to say a few select words more.

It's a US-imported problem facing doctors increasingly in Europe now, too: litigation based on lawyer greed. Adding that to increasing numbers of competency complaints and unreasonable expectations and demands by patients and family members who think Dr Google bests all actual physicians makes being a physician a windy spot in Britain, where every doctor can expect to be sued about four times during their careers.

The relieved smile and a tight handshake Sherlock had received from his accused colleague had not alleviated the deep frustration brought on by the awareness that this was going to happen over and over again, and one day he is likely to be the one on the firing line. After all, he'd already come close once.

The public no longer wants to believe that their doctors mean well and are doing the best they can, instead of killing and maiming their patients deliberately or out of carelessness. Cases such as that of the serial killer GP Shipley haven't helped but, all in all, Sherlock has found the morale of his fellow physicians to be plenty high enough to warrant trust from the general public in their abilities. The system they work in is in trouble, but the core of the profession has not yet withered away or gotten replaced by laissez-faire capitalism.

 _If only doctors were granted peace and quiet to do their damned jobs instead of wasting their time fighting against bureaucracy, general idiotism and goddamned lawyers_! Sherlock envies his colleagues in countries where healthcare is not taken for granted, and the work of its employees is still valued. Surely such places still exist?

He makes his way to a section of sharp, quick notes following the more languid start of the Sarasate piece, and the aggressive bow work allows him to vent a bit of frustration. He makes the ensuing _con passione_ phrase a little bit angrier than usual, lifting his bow from the strings slightly so that he can properly attack them for a set of double notes. The downright screechy tone fits the piece in a pinch, but it's hardly what the composer had intended. This is followed by a long, boring, roller-coaster-like glissando that's more a demonstration of dexterity than musically enjoyable.

He isn't in the mood for this composition, not at all, but he had decided to work on it this week. _To what end_? He doesn't have a performance booked which would create a deadline, so what is the bloody point of playing something that in his current state of mind feels like torture?

He puts the violin and bow down on the coffee table, grabs the sheet music and slams it face-down on the coffee table. He then digs around in his music cupboard for something a bit more therapeutic, finally settling on the _Presto_ part of Barber's violin concerto. Right now, the composer's instructions of playing it _liberamente_ are just what he needs, and there is no one here to judge him if he goes a bit overboard and turns it into an entity of reckless abandon. Since he has been playing the Barber concerto since he was nineteen, his digits dance on the fingerboard as though the music was coming from a pianola.

He sets the standards for himself, both at work and with his music and his relationship with John. He knows they are high. But, why are they still never enough? No matter how good a surgeon he is or becomes, he can't escape the things people know and assume about him and his past. They look at him like a liability as soon as he puts down the scalpel. Even John thinks that he needs the support and infrastructure of high-end equipment, a state-of-the-art, climate-controlled operating room and the best-trained staff available to be able to do his job. 

John seemed impressed by how he'd managed in Afghanistan, has even voiced it, but if he were anyone else, would John have been as proud? The way they look at him at King's is not the way people had looked at him at Camp Bastion. There, he had been treated like a surgeon, nothing else. _No prejudice. No baggage. No condescension_. There, he had felt like an equal to his colleagues even when he hadn't been operating. They had assumed that his judgment, his bedside manner, his intelligence, his composure, and his skills of human interaction were up to par, and all the ways in which he may have appeared odd were probably chalked off to the fact that his partner was gravely injured.

Right now, he wants nothing more than for people to look at him like that again.

Concentration shot by his agitation, Sherlock barges onto the trioles on the second-to-last line of the first page of the Presto part of the composition, cursing under his breath when the arpeggio-like progression turns into a steady stream of mistakes.

Suddenly, he is startled so severely by a hand on his shoulder that he nearly drops the bow.

John staggers back, hands raised defensively. "Sorry! I thought you heard me coming in."

Sherlock gives him a glare, heart still pounding.

"Or maybe not, seeing as you were abusing that poor violin so loudly." John glances at the music stand. "What did Mister Barber ever do to you?"

"Existed," Sherlock huffs and launches into the composer's devilish trioles again.

  
-o-0-o-0-o-0-o-0-o-0-o-  
  


A week later, Sherlock finds Alice in the OR floor break room, filling out some final paperwork for the completion of her training. The headlines of two pieces of paper peeking out from the pile catch his attention. Looking slightly embarrassed, Alice passes them over after he asks to see them. He should be privy to all such educational documentation—the young woman is _his_ registrar, after all.

"The Deanery demanded two additional final assessments," Alice tells him.

The summaries of these assessments have been written by Lestrade and a neurosurgical consultant called Gloria Newick—a recent arrival in the unit. The Deanery demanding such a thing explains why Alice had been pulled out of Sherlock's service for several weeks before Easter to work under her.

As a rule, only one statement similar to the two Sherlock had read through is required and is written by the consultant in charge of a registrar's training. Sherlock had filed his own a month prior. Now, it appears that his words had not been good enough even though he had been meticulous in formulating a thorough and fair assessment addressing all the areas mentioned in the instructions.

He marches to Lestrade's office to demand an explanation.

"They know about the difficulties you had with Alice at first. A gastrosurgical reg she had confided in talked to his PD who informed the Dean. No official inquiry was made since Alice hadn't filed a complaint, but they still wanted two additional assessments to make sure you weren't giving her a favourable one just because you wished to get rid of her."

"If I wanted to get rid of someone, I would hardly give them a positive review," Sherlock scoffs. “Why am I always being second-guessed and subjected to double standards?”

"You were the one who swore blind that you couldn’t and shouldn’t ever take charge of training a junior."

It's true; Sherlock had been the worst sceptic regarding him training Alice. John had been the only one who had never wavered in his belief that Sherlock could train someone. Is he becoming disillusioned in his own abilities yet again? What if it isn't other people he most acutely wants to convince of his abilities, but himself? It could explain why he's becoming more and more prone to anger and irritation when others act as though he needs to be babysat, mollycoddled and _managed_. Before, those things had allowed him to concentrate on what he did best, but he's getting more and more aware of how they also imply that he isn't to be taken entirely seriously as a physician because he can't be trusted to manage alone.

 _'High-maintenance Holmes',_ his school peers had called him, after some incidents which had been connected to the horrid fabric of the Harrow school uniform, the food offered there, and a near-meltdown after what they'd called an exercise in character-building which had included having to run around in the mud playing team sports. He is vulnerable to distraction and sensory overload, but he can withstand more than people think.

Maybe he needs to start defining the limits of his abilities instead of letting everyone else do so for him.

" _A medical career would be a mistake_ ," his brother had told him after he had already gone through two years of medical training. _'You are a mistake'_ , is what Mycroft should have said, had he aimed for a bit more honesty.

Yet, here Sherlock is, years later: a consultant at one of London's most prestigious medical units. If he'd let Mycroft tell him what he can and can't do––

He's so, so sick of having to waste his time trying to learn the complex set of rules in the NHS regarding dealing with others and manoeuvring around the expectations of other and the ridiculous bureaucracy that, for long, has had nothing to do with good patient care whatsoever. _No wonder it tires John out since he has to put up with a lot more of it._

He and John have been doing well lately, but the man seems to go through periods of frustration Sherlock does not know how to alleviate. Despite John's assurances that fixing his mood or his motivation are not Sherlock's job, he _wants_ to do something to help. It needs to be something John would enjoy, something he'd want to do to break the monotony. The ideal solution would be something that is mutually beneficial. Holiday trips are Sherlock's usual attempt at lowering his fiance's stress level, but their effect doesn't last long once they return to their life in London.

Perhaps he needs to do some out-of-the-box thinking this time regarding what would serve both his needs and John's.

 

-o-0-o-0-o-0-o-0-o-0-o-  
  


A week later, Sherlock's outpatient clinic day does nothing to improve his mood, which hasn't climbed back to his usual, tolerable balance between chronically bored, occasionally exhilarated, and generally restless when John isn't around to temper his whims.

A mix-up with appointments ruins his first hour: the Trust has a new, automated system that sends patients invitation letters which has been malfunctioning and also confusing the hell out of elderly patients with its complicated SMS functions. Once they get the scheduling conflicts sorted out so that he and Marie can actually start sorting out the patients' medical needs, they're already running forty minutes late.

The third patient of the day is one whose grade three astrocytoma was wrapped around several cranial nerves. Sherlock had spent a hair-raising eleven hours carefully removing it so that the woman could have a chance of a cure. Now, it turns out that she is deeply unhappy by the fact that the scar on her scalp is a little longer she thought it would be. It will be concealed underneath her hair, but she's still upset and takes her time complaining and wrecking their schedule even further.

It takes plenty of warning glares from Marie and all of Sherlock's self-restraint not to blurt out a few choice words about priorities. In the end, Marie slips him a note: 'just say sorry'.

He does, hating his tone when he tells the woman that he regrets not having informed her properly about the precise measurements of the scar, even though he could not have even made an accurate estimate before he saw her with her head shaved. She leaves with a huff.

Next up is a ninety-seven-year-old woman. She lives in a care home, is incontinent and bedridden, and mute due to advanced dementia. She is accompanied by three middle-aged offspring who are demanding that the patient's expansive and outstandingly malignant glioblastoma be operated on.

"It won't improve her quality of life, and the complication risk is too high," Sherlock says.

"What if this is the cause of why she's like this? What if they misdiagnosed the dementia?" her son, a schoolteacher, suggests eagerly.

"In her age, glioblastomas are fast-growing tumours. She has lived at the care home in Blackheath for seven years. It's likely that the tumour began to develop less than a year ago."

"What does it mean that the complication risk is too high? Does that mean you won't do the surgery?" the son asks.

"This is ageism! If she were younger you'd operate, wouldn't you?" a daughter pipes up.

"In her situation, regardless of age, the operation wouldn't buy more than a few months more of life."

"Are you saying her months are worth less than someone else's?"

Sherlock decides to try a different angle. "She would likely require extended intensive observation after the operation, but no intensive care unit would admit her."

The daughter crosses her arms. "That's ageism, then, too."

"Age is not the deciding factor, though we do know that very elderly patients do not recover as well from intensive care as younger patients do. Intensive care will not improve her baseline functional level."

"What's that even mean?" another son asks.

"She spends her days in bed. Intensive care after surgery would leave her even less able-bodied than that, and no intensivist would be likely to admit her. There's also the fact that she cannot understand what is happening to her. If the procedure can only marginally delay the course of the illness, it could be considered unethical to expose her to such a stressful experience. There's also the fact that none of you has obtained the Medical Power of Attorney needed to make this decision on her behalf."

The son interrupts with a curt, "Yes, well, she left it too late, didn’t she. No will, no nothing."

This threatens to break out into a family war right in the room, with the three children talking over one another.

"Mum understands, she just can't talk. You understand, Mum, don't you?" The daughter strokes her mother's thin, grey hair, and receives neither a single word or even eye contact as a reply.

The elderly woman had been brought into the room on a trolley, and at no point had she made eye contact with Sherlock or Marie or shown any awareness of where she was.

"Removing a part of the tumour—which is all I could do for her—would not change the course of the illness or improve her functionality, only delay the inevitable. In fact, one might argue that perhaps the most merciful course of action could have been to not subject her to the second MRI and other full tumour diagnostics at a hospital because it's not going to lead to anything."

The son gapes. "How can you say that? That they should have not even diagnosed her? What if she'd had a stroke and not a tumour?"

"In her condition, she is not eligible for intensive care or thrombolytic treatment for stroke. There is little we could have done for her beyond basic supportive care."

"So, she's old, and she's got Alzheimer's, so you don't give a damn about her, is that it?" the daughter accuses, pointing a forefinger at Sherlock. She has risen to his feet, and the tension in the room is palpable.

Marie steps in. "We're only trying to find the option that will cause her the least amount of extra stress and pain. You need to understand that, without a DNR or a Medical Power of Attorney in place, your mother’s situation is up to the doctors who are treating her."

"I could never remove all of the tumour, and it will grow back fast, and expand," Sherlock explains, hoping that he is being understandable enough for a layperson. "Trying to keep it in check would lead to more operations, and any one of them would leave her in a condition where she would need intensive care. Intensive care is, as the name says, an intensive, stressful intervention that carries risks, and it cannot make her better than she was before the need for it arose."

"Ageism is what this is!" the son accuses.

Sherlock curses inwardly. They're going around in circles. "As I said, age alone is not a contraindication for anything. But, your mother has diabetes, hypertension, kidney malfunction and advanced Alzheimer's disease, which together weigh greatly on the scales. Those illnesses mean that her reserves for recovering from surgery are nearly non-existent. The same goes for intensive care, and resuscitation."

"You're saying… that she shouldn't even get CPR?!" the daughter yelps, eyes wide.

"There's a lot we can do to make her comfortable during the rest of her life," Marie says with a soothing tone.

"Comfortable? You're leaving her with brain cancer, how can she be comfortable?" the son demands.

Sherlock understands the son's disdain for the expression; that phrase, ' _to make someone comfortable'_ had baffled him, too, but Marie has taught him that it's a standard-issue platitude when talking about palliative care.

"You've finally understood the gist of the issue," Sherlock says, voice loud enough to get everyone's attention. "She has brain cancer, of which she _will_ die, surgery or no surgery. The only decision left to make is whether we put her through the additional stress and suffering of an operation and its aftermath before she dies, and those are things she cannot even consent to and which she does not understand. Usually, laypeople state as their wish to die somewhere else than a hospital with their family, instead of being hooked up to monitors at the ITU."

The daughter begins sobbing inconsolably, and the older son glares at Sherlock. "You're _heartless_. You shouldn't be a doctor." With the younger son in the lead, the family storms out, muttering about getting a second opinion, which depresses Sherlock even more.

Marie wheels the patient out to the corridor to wait for transport back to the neurosurgical ward. Sherlock, tapping a pen against the desk, decides to ask Alice to refer her to hospice.

The next patient has a meningioma compromising her pituitary function, but when they try to place her in a timeslot for surgery, she keeps insisting there are many business-related appointments she just can't reschedule. Sherlock goes to get coffee, leaving Marie to deal with the scheduling issue.

His second-to-last patient of the morning half of the clinic spends most of their appointment quizzing him about the dangers of anaesthesia because some distant relative had died of something during an operation in the nineteen sixties. Sherlock calls John to see if he could come in and talk some sense into the patient, but John's number is repeatedly busy. Finally, he gets hold of one of John's colleagues, a sensible Latvian bloke with a strangely reassuring beard.

Just as Marie is escorting the patient out and giving him instructions on where to meet up with anaesthesia consultant, Sherlock's work phone rings. It's the Ward Sister of the OR, informing him that they will have to cancel two of his three cases for tomorrow because the PACS imaging software server has crashed, and the new NHS Safety Resource Management Manifesto says that no elective surgery is allowed while there is a widespread interruption in IT services. This means that several of today's cases must be postponed for tomorrow.

"I don't know how much more crap I can take today," Sherlock admits to Marie after she closes the door behind the patient who had lingered in the doorway to pose more strange anaesthesia-related questions.

"Well, at least you can just sit and listen at that MAST thing this afternoon," she says.

"It's _today_?"

Sherlock digs out his phone from his jacket pocket and checks. He'd forgotten the whole thing because these _Mandatory And Statutory Training_ seminars, which are enforced on all personnel once a year, are the lowest thing on his priority list. Having nothing to do with actual medicine, the sessions consist of various hired-in idiot business consultants sharing their alleged wisdom to NHS employees about fire drills, the frameworks of customer-oriented care and cultivation of lean innovation.

At least he can grab a decent lunch on the way at some restaurant worth their salt.

  
-o-0-o-0-o-0-o-0-o-0-o-

  
Sherlock picks a pasta dish at a highly regarded upmarket Italian halfway between King's College Hospital and the Southern London NHS Centre of Excellence In Care. If John were with him they'd go for something more down-to-earth; John's preferences in takeaway tend to reflect his working-class background. The good food cheers him up, but only marginally.

Upon arrival at the Centre of Excellence, a young and depressingly enthusiastic-looking young man tries to give him a copy of the latest MAST Workbook. According to the photocopied seminar programme stuck between the pages, today's first speaker will be a twenty-something male with a background in the poultry industry. His topic is listed as: ' _Maintenance of empathy as a tool for economic stability in healthcare'._ Sherlock wonders how this man would have handled the patients and their family members he's had to interact with today, and whether he'd faint at the sight of the surgical field of a brain tumour removal.

According to the program, the second part of the seminar will be a practical demonstration in the use of fire extinguishers. There's one standing next to the elevator a few feet from where he's standing. Lingering there with a cup of stale coffee, he reads the instructions from a tag hanging from its neck. _Remove pin. Aim at fire. Press handle._ Hardly rocket science.

His phone rings; it's the Ward Sister yet again. It turns out that the IT department hasn't validated the security certificates of the web browsers running the imaging software, and that the remedial update cannot be done until the day after tomorrow. So, for safety reasons, all elective surgery must be closed down for two days.

"We are asking all surgeons to explain the situation to the patients whose cases will be postponed", she explains. 

Sherlock suggests that a registrar should take over that duty since he's elsewhere, or they could just look at the imaging results through the parallel-running old system everyone still uses, anyway, because it's faster than PACS. The Ward Sister says that's what they've been suggesting, but the Litigation Liaison of the Trust says that the PACS distributor could sue if they continue doing that.

The poultry consultant is standing by the lecture hall door, gesturing for him to come in since every else has found a seat inside the hall already.

Ignoring whatever the Ward Sister is now saying, Sherlock rings off and walks out, shoving the Workbook into the consultant's hand as he marches past and straight through the exit.

_This isn't what I trained for._

He walks to a newsagent across the road and buys cigarettes. He's supposed to have quit and hasn't touched tobacco in six months, and John will yell when he smells and tastes the smoke on him, but right now, that doesn't seem like a high price to pay for a bit of pharmacological help to his mood. Anger would be excellent and proactive right now, but he can't muster up anything better than resignation.

He finds a park bench and smokes four cigarettes one after the other; the buzz of the nicotine is short-lived but glorious. There's probably some guideline or directive or action initiative or charter that bans NHS surgeons from smoking in public. Rules, rules, rules, rules—all designed to keep him from doing his job.

_When did surgeons stop being surgeons and become…whatever this is? Prisoners of the system, and something people keep trying to prove I'm not cut out for?_

_  
_ -o-0-o-0-o-0-o-0-o-0-o-0-o-

  
He's never been a very good sleeper. The relief of getting rid of the halo rig had launched a blissful period of a much steadier schedule and quality of nighttime rest than he remembers, but in the next weeks, all such progress is shot to hell. He keeps waking up several times a night because things are going around and around in his head and never get resolved. He's trying to solve the puzzle of his life, to find the one level to pull, the button to push to get back to the mostly happy and productive state in which he's been since he met John, but it eludes him like a mirage moving further as he tries to reach it. Where he used to see challenges and opportunities, are now just hardships and a repeating cycle of failure. Sometimes he doesn't even know whose expectations he keeps failing to fulfil the most—his own or other people's. No matter how many papers he publishes, how brilliant his inventions are, how outstanding his complication rates and how great his reputation is for his technical skills, there will always be an invisible wall between him and the rest. 

He knows this mood well. As long as he senses it's a transient one akin to a passing rain cloud everything is fine, but now, it's shifting from a weather event to a climate change, and he worries if it will pass at all. That's the worst part: the not knowing how long and how badly it will hold him in its grip. When it's at its worst, he cannot even imagine how he has ever managed to shake it off in the past.

Early on a Monday morning, after waking up at four and tossing and turning ever since, he crawls out of bed, slips into a dressing gown and goes out to the balcony. His skin feels tight and prickly, the old scars on the crooks of his arms ghost twinging with the memory of the only thing that always empties the tar pit his mind becomes when it's like this. He misses the way heroin and cocaine filled the receptacle of his consciousness with something he could just float through into oblivion, but he knows he's not going to use. He can combat the temptation. Succumbing is not a sustainable state, and he has so much more to lose, now. John, his career. The career _he_ chose.

 _'Why do you want to make your life more difficult than it already is?_ ' he mouths wordlessly, mocking the expression on his mother's face when he had parted ways with Victor and went home to announce his intention of applying to medical school. 

There's an empty travel-size shampoo bottle inside the hollow balcony balustrade that now contains cigarettes and a slim lighter. He digs them out, aware that it's an addiction, too. A chemical comfort to reset his misfiring brain receptors. A false sense of calm.

How does John do it? How does he put up with the ridiculous and unfair stresses and demands of their work? John has struggled with identity and career issues, but it must be that he has managed to resolve them because he has the skills to manage with other people. Sherlock doesn't have that luxury of normality which his partner possesses.

He knows he's gotten far in his life. He knows he has beaten prejudice and staggering odds to construct an admirable career. Would he have done it all if he'd known that everyday life would still be such a struggle to be understood, to be heard, to not be judged?

He rolls a lit cigarette between his fingers. John will tell him to quit if he finds out. Everyone wants him to do something differently.

He's getting cold in the wind wearing only his pants, a T-shirt and his blue gown, but focusing on that sensation is a welcome distraction from the stagnation of his thoughts and the bleakness of their contents.  
  


-o-0-o-0-o-0-o-0-o-0-o-0-o-

  
"Morning, sleepyhead," John teases him a week later on a Saturday morning.

Without opening his eyes, Sherlock can tell he's brought an espresso and the paper, which he has already read since it rustles more than it would if it was still rolled up tight.

_It must be past ten in the morning if John has already had breakfast and gone through the entire Times._

The mattress dips as John sits down next to him. The warmth of him close by doesn't feel reassuring today, just indifferent.

_Like everything else._

"We could see a movie, check out that new Australian steak place near the Electric." John knows the small cinema in Shoreditch is Sherlock's favourite; formerly called The Aubin, it has armchairs, footstools and cashmere blankets.

They have nothing planned for today—not that Sherlock is even interested in planning anything. He burrows deeper under the duvet, pulls his knees to his chest, says nothing.

"You okay?" John asks. "You're not getting sick, are you? They had to close half a cardiology ward for the weekend because so many people are down with the seasonal flu."

"I don't have some pedestrian flu," Sherlock mutters.

"No, of course not, you only go in for fancier germs." John pats his duvet-covered hip with a chuckle.

Sherlock realises that John hasn't been at home much this week due to several call shifts and a meeting out of town. Usually, Sherlock makes note when they haven't spent too much time together and starts longing for John's attention during the weekend, but now he doesn't even remember what he had done in the evenings. Last night, when John had come home, he'd already been asleep. Uncharacteristically, he'd gone to bed at around ten in the evening because nothing he could have used his evening free time for had piqued his interest.

"How was your week?" John asks.

Sherlock turns to his back, drags open his lids. John has opened the bedroom blinds, and the sunlight is bright, bringing forth a grimace.

"I don't know." It all blends together, now: the days, the surgeries, the red tape, the prejudice towards him, the frustrating and confusing conversations with patients, the thousand little social blunders he makes all the time. At least they don't bother him that much right now, sinking instead into being a part of the sticky, grey gloom of the existence that is his life and his work and his working life and that's all there is to it, really.

For the next twenty, thirty, forty years, he will continue to be Sherlock Holmes.

John leans in to kiss him on the cheek. "One of those days, huh?" He puts the espresso he's brought on the bedside cabinet on Sherlock's side, then goes to lie on his own side of the bed on top of the half-crumpled duvet. He turns to his side, facing Sherlock, and raises his torso slightly to lean his chin on his palm. He runs a finger down Sherlock's bare arm that's resting on the duvet, trying to get him to look at him. "Want to fool around?"

Sherlock continues to glare at the ceiling. Normally, he'd welcome John's suggestion, but even sex feels rather pointless at the moment. John continues to draw slow circles on his arm, but the touch is too light and feels like it's polarising his nerves and making the hairs on his arm stand up. He withdraws the appendage and rubs the skin vigorously to stop the infuriating sensation.

Then, he scrambles to sit up. "How do you _stand it_ , John? The idiots, the bureaucracy, the dullness of it all, the repetition, the struggling with the same things over and over and over again?"

Worry etches lines onto his partner's forehead. "I've learned to laugh about it, I guess. What's that old saying again, ' _courage to change the things we can, accept the ones we can't, and the wisdom to know the difference_ '?"

"I know the difference," Sherlock groans. He most certainly is chronically aware of the differences between him and other people.

John's mouth shifts to a thoughtful line. "I get it, though, what you're saying. I guess that's why I joined the army because I didn't want to think that I'd already seen it all, that I was getting into a routine, that nothing challenged me much. Took me a couple of tours to see that the grass isn't greener elsewhere, it's just a different colour."

Sherlock runs his fingers through his hair, which must look a fright. He feels like a stale mess, but he lacks the energy to do anything about it. His unruly, labour-intensive hair is yet another part of the taxing cards he was dealt, the many things he has to do to manage in the life he's chosen to fight his way through. Just once, it would be nice to live as not someone else, but to experience how people would react if their first encounters with him weren't always laden with rumours and expectations and assumptions. If he could just once be the one to define the parameters of who he is. Instead of being _the surgeon who is this and that_ , he'd be just a surgeon. Just… _him_ , whatever that means. John seems to see that person, but nobody else here does.

"Where's this all coming from?" John asks. "Has something happened?"

"No."

Maybe that's precisely the problem. Nothing happens, everything stays the same, and he's trapped in days and weeks and months, the contents of which he can predict with paralysing precision.

There has to be somewhere where things are different. A place where he could gain the perspective that John seems to have found from his misadventures abroad.

"We still haven't decided about today. Want to stay here?" John asks, probably meaning the bedroom or their flat. "Or go somewhere? We've got the whole weekend. Would a change of scenery help?"

Sherlock flings the duvet away and reluctantly plants his bare feet on the floor.

As usual, John—without even realising it himself—may have isolated the problem and suggested a potential solution. But, it can't be turned into reality in just one weekend.  
  
  
  
  


 

**Notes for the Chapter:**

> [Here's the piece](https://www.youtube.com/watch?v=-My4X_OBNtI) Sherlock is playing at the beginning of the chapter, performed by Rusanda Panfili. And, [here's the Presto part of the Barber violin concerto](https://www.youtube.com/watch?v=Q5hP5IikHcI), performed by Hilary Hahn.
> 
> There are two wonderful books written by surgeons on the topics of mistakes and complications. The first is [Do No Harm](https://www.theguardian.com/books/2014/mar/30/do-no-harm-stories-brain-surgery-review-henry-marsh) by renowned British neurosurgeon Henry Marsh, and the second [Complications](http://atulgawande.com/book/complications/) by Atul Gawande, who is an American general & endocrine surgeon.
> 
> _*climbs on soapbox*_
> 
> Litigation in medicine is a complex topic, the finer details of which fall outside the scope of what I can address in a chapter note, but I will say this much: a highly litigatory culture makes medical care both more expensive for everyone, and LESS SAFE for patients. It raises insurance premiums for physicians and healthcare units, increasing the cost of care which is then leeched from patients and insurance companies (a vicious circle). Legal battles are long, costly, public and will not bring back a deceased loved one or return them to health. Of course, absolutely, yes, doctors who deliberately harm patients or cause them harm through gross negligence or incompetence should face the consequences, but there are channels for this—official channels. For more complex, shades-of-grey medical issues, I do not believe for a second that dragging them through the courts where they are assessed by people who are not medical experts, and many of the players involved are motivated by money, not by finding the truth. A highly litigatory culture does not encourage healthcare employees to talk openly about mistakes so that others could learn from them—instead, in fear of consequences, mistakes are concealed, and doctors are told never to admit them to anyone. How could open discussion on how to make things better and prevent a mistake from happening again could ever happen in such a culture? A high litigation culture also entices doctors to do unnecessary studies (which may also carry risks) "just to be sure", or to downright decline treatment from some patients because they're deemed higher-risk-than-average. Obstetrics seems to be particularly affected by this.
> 
> Mistakes happen to every healthcare employee, just as they do for everyone else in all professions, and it's a fucking waste that good employees are allowed to be emotionally wrecked, and their careers destroyed through unfair consequences as a result of a singular, uncharacteristic error. Lengthy court cases can also emotionally suspend people in limbo and a yearning for vengeance when a different sort of procedure for investigating the mishap could have helped all parties heal and move on. When a healthcare employee has done their best under demanding circumstances and limited time and resources and an accidental mishap occurs, they can become what has been referred to as [a hidden victim of medical error](https://www.huffingtonpost.com/amy-d-waterman-phd/medical-errors_b_2063609.html?guccounter=1).
> 
> I believe that high-litigation cultures have been born and they persist in some countries because people don't realise that there are alternatives. It is very possible to create channels for addressing patient and family concerns about medical misconduct and to even award monetary compensation without a single lawyer getting involved, or the money having to come from one individual's pocket. Such systems do exist in many countries, but the US-borne high litigation culture is creeping into these places, and it's already causing doctors to leave. Such countries also have systems where incompetency claims are investigated by experts in a manner that does not expose those involved to tabloids and barbaric treatment. I find the UK system of investigating such claims downright cruel, and it is not surprising that many doctors who are dragged through the process contemplate or commit suicide. We all want safer healthcare and motivated healthcare employees, but those things are not going to happen if the topmost thing on everyone's mind is suing or getting sued. I love working in a country where a doctor can explain to a patient why things went wrong and say: "I'm so terribly sorry that I made this mistake; can I help you make things better and seek compensation?" without fearing that it's the end of their career.


	3. The Proposition

> __  
> _You can measure the depth of the sea but what about a man's heart?_  
>  —Malawian proverb  
>    
>    
> 

John's key fob is acting up again, refusing to let him into the locker room corridor in the basement until he has spent a long while waving it in front of the electronic lock like a madman. Sherlock's key always seems to work even if it's still in his pocket. It's a bit like with cabs—John can never hail one while Sherlock barely needs to lift a finger and one will materialise.

This afternoon, John needs to fend for himself because a glance at their shared online calendar had reminded him that Sherlock would be heading to see Doctor Pichler in the afternoon and make his way home from there. He often did some shopping on the way, popping into his usual tailor or a hair salon; both are things to which John has little interest in accompanying him.

After changing out of his scrubs and heading up a short set of stairs to the staff entrance, he reaches out to open the door—and yelps, startled, when he nearly bumps into Sherlock.

Sherlock looks equally spooked and dismayed. He isn't wearing his coat, just his jacket, and the wind has tousled his hair.

"How are you––" he starts, just as John opens his mouth.

"What are you still––"

They both snap their mouths shut, and Sherlock clasps his hands behind his back.

John checks his watch. "Aren't you supposed to be at Harley Street by now?"

Sherlock sniffs, lifts his chin defensively. "Didn't feel like going."

"I'm actually surprised you've continued to see her now that Alice has nearly got her CCT."

Sherlock's lips pinch tight. John can easily read this as evasion.

"I should get my coat," Sherlock says, and turns slightly sideways to head past John for the stairs.

If he had been waiting for John at the car, why hadn't he collected his coat before?

"What were you doing out there? And where were you earlier when I tried to call you?" John asks his receding back.

John had wanted to ask if Sherlock could bring takeout with him in the evening. He'd made sure to call when he knew Sherlock had a break from outpatient appointments. He hadn't answered his mobile, so John had called the landline at the neurosurgical clinic. Marie had told him, somewhat sheepishly, that Sherlock was "out, on a break".

Out doing what?

"I'll only be a minute," Sherlock replies over his shoulder, and even though he's now at the bottom of the stairs, John sees him slip something into his pocket.

He's been acting strange, lately. Not erratic, not all that worrying, but… out of sorts. He's moody, sulky, non-verbal and seems to have no desire for anything he usually likes to do in the evenings. He has stopped seeking John's attention to the extent he used to. He's restless, but instead of his characteristic bouncy enthusiasm he seems to emanate a strained, frustrated, even vengeful kind of energy, when he isn't glued to the sofa staring at the ceiling. John has been meaning to sit down with him to take all this up, including his recently decreased appetite.

Sherlock's gloomy mood seemed to culminate in a weekend when he didn't seem to have any interest even in spending time together. John had wanted to believe it was a transient thing, but things haven't really improved. Sherlock seems to be going through the motions at work, and the spark is missing. Usually, on their commutes, he tells John about intriguing or challenging cases, laments about things that annoy him, has monologues about this and that he happens to be interested in. Lately, he has been looking out the car window, quietly, and when they get home, he _naps_. Sherlock, who has never needed much sleep and can act like the Duracell bunny when he gets enough intellectual stimulation at work, has just somehow… wound down.

Nothing new has happened in their lives. Everything is fine, everything is as it has been. As far as John knows, there's nothing particular going on with either of their families, there are no complaints or court cases going on related to their work, and Sherlock's research projects are advancing on schedule. He's just had an article published in _The Lancet_ , which is a veritable feat.

John has seen such behaviour from Sherlock before, but then there were obvious reasons for it: he was recovering from his accident, stuck in a halo rig, and John was struggling to return to civilian life after his own accident in Afghanistan. Their relationship back then was a wreck, but they fought their way through with the help of some professionals.

So, what's wrong, now?

Looking at it objectively, John can only come to one conclusion: Sherlock appears to be depressed, and it's not going away like his more transient frustrated or dark moods. It's been weeks, and he's also grown a bit secretive. When he's not sulking or sleeping, he seems to be doing something on his laptop about which he hasn't explained anything about to John. It's the one thing that seems to still be able to hold his interest; movies or TV don't qualify, anymore. He hasn't even been playing his violin much lately.

Now, there's a new development: disappearing outside several times during the day and trying to conceal it from John.

He has a hunch what's going on, and to verify his theory he needs to check the man's pockets. Not that their contents would explain _why_ Sherlock has succumbed to old habits. Unless it's worse than John thinks, and what he's using is something that would both wreck his mood _and_ jeopardise his career.

 _Please, God, don't let it be that_.

Sherlock jogs up the stairs, buttoning up his coat. John crowds him on the landing and takes over the task, pretending to just want a bit of closeness, but instead of continuing what Sherlock had started, he slides his hands into his partner's jacket pockets.

He exhales when his right hand encloses around a rustling, plastic-covered packet of cigarettes, and his left around a lighter. His worries have not abated, but at least the worst-case scenario hasn't come through.

"I'm not using, if that's what you suspected," Sherlock snaps after studying John's expression which may well have betrayed his relief.

John drops his loot into a bin, and Sherlock's jaw drops in indignation.

"I have no idea how you concealed the smell and the taste. You were doing so well," John laments.

"Ah, yes, the performing monkey should be grateful for all the praise."

"What the hell is that supposed to mean?"

"What does it matter what it means? What does it matter if I was _doing well_? What great happiness has quitting ever brought me?"

"Not dying of lung cancer?" John suggests with raised brows.

Sherlock finishes his buttoning and starts striding for the entrance.

John follows him. "You do have a point in that lately, not much seems to matter to you."

"Maybe I'm just seeing things more clearly."

"Things such as?" John unlocks the car and they slip in, Sherlock commandeering the shotgun seat.

"Couldn't you just continue to be as spectacularly ignorant as you usually are?"

"Well, you're being equally spectacularly ignorant if you think that after all we've been through, I wouldn't notice or care if you smoke? Or if I think there's something going on with you?"

Sherlock throws himself against the car seat after strapping on the seat belt with an angry huff.

"Have I done something to––"

"No."

"What, then? Sherlock, talk to me, _please_."

"How will that help? How will it change things we can't change? The NHS continues to be populated by imbeciles, the sun goes around the earth, maggots continue to eat our corpses when we're dead."

John brakes and the car comes to a halt by a pillar near the garage entrance. "The _sun_ goes around the _Earth_?"

Sherlock flicks a wrist at him. "That's what you think is important? Semantics?"

"It's not semantics, it's the bloody solar system. Primary school stuff. You do know what goes around what?"

"Well if I ever did, I deleted it. My brain is my hard drive and I won't keep anything in it that has no bearing on my life."

"But it's the solar system!" John argues, putting the car into gear and heading up the ramp after the automated doors open.

"What does that matter? So we go ’round the sun. If we went ’round the moon or round and round the garden like a teddy bear it wouldn’t make any difference."

Disheartened by the outburst, John pats the steering wheel as he waits for a light to turn green. "I'm just trying to help. If you don't want to talk––"

"No, I don't. I want a solution. I'm working on it."

"To what?"

"Everything."

John huffs. "Well, that's vague." He can't help but smile a little; Sherlock never does anything by halves, and that includes sulking. He does it with dedicated flourish, and it's better than the paralysed silence that has been taking over in the evenings.

When John had talked to Marie, she had said she had also noticed that Sherlock had seemed… off his game. Quiet. Not making much of an effort to engage with patients, leaving the establishing of all rapport to her.

"It's like he's given up," Marie told John. "He was doing so well."

"Yeah, but any encouragement I offer, he just looks like he wants to bite my head off."

He focuses on managing a roundabout, then glances at Sherlock who's staring out the side window, fingers drumming on his patellas.

"You do know you can talk to me?" John asks.

"Yes." Sharp, curt, dismissive.

"Things aren't okay, are they?"

"No."

"Well, okay." John hadn't expected such a frank admission. "What can I do?"

"Nothing. I need to be the one to solve this."

 _He needs a project_ , John thinks. _He needs something to engage that brain if he's got nothing on in research or at work and he's getting bored and frustrated._

"Have you thought about the wedding?" John asks.

This rouses Sherlock, who had seemed about to descend into inertness as he stared out the window. "What?"

"Our wedding. Usually, that's what an engagement leads to."

"I never assumed you were very interested in such melodrama as a ceremony and reception."

"Well, I don't want a huge, awkward reception, but maybe a dinner with family and some friends, that sort of thing? You have an eye for clothes and furniture and all that, so maybe you could plan something."

Sherlock frowns. "You want me to plan a wedding?"

"Only if _you_ want to. We could just pop into the magistrate's office or something if you'd prefer to avoid a party, but I assume neither of us intends to do this more times than once in my life, and since Mycroft's still single––"

"And very likely to stay that way," Sherlock cuts in.

"––your parents would probably enjoy being included."

Sherlock primly arranges his hands on his lap. "I don't really know anything about weddings."

"Well, I know fuck all, too, but let's make it ours, yeah? Something small and tasteful." John makes use of a red light to study his partner's expression. Nothing has changed, there. Still gloomy. Still disinterested.

Sherlock exhales. "I suppose I could put something together."

 

-o-0-o-0-o-0-o-0-o-0-o-

 

"Hello?" John calls out after opening the door to the flat a week later. He expects Sherlock to be in the flat since he's post-call and had left for home in the morning after operating on a ruptured aneurysm all night.

There's no answer, so John hangs his coat in the rack, and takes the mail he'd picked up from the box in the downstairs foyer to the kitchen. There's a half-drunk mug of tea on the breakfast bar, but no sign of Sherlock having eaten anything: John had cleaned the kitchen last night and finds no plates in the sink or dishwasher—Sherlock never bothers to put them there—and nothing seems to be missing from the fridge, either. Maybe he'd grabbed something on the way home. _Most likely not_.

John climbs the short set of steps to their bedroom and changes out of his suit to jeans and a T-shirt. Sherlock isn't there, nor is he in the bathroom or sitting room. That only leaves the guestroom where John sometimes naps after being on call.

Quietly, he enters and stops near the door. Sherlock is lying on the bed, snoring quietly on top of the bedspread. His laptop is open next to him, with a notebook and a pen set next to it.

John sneaks closer and leans in a look at the screen. Sherlock never locks it, so a gentle tap on the touchpad awakens the machine. There are two windows open side by side; one is a list of vaccination recommendations for travellers and the other a government advisory website about visa requirements. The notebook which lies half under Sherlock's palm is open, and there he has scribbled down what look like rain and temperature charts.

John steps back, leaning his hip on an armchair, watching his partner with a smile. _He must be planning a surprise honeymoon._ It's obvious that Sherlock is going through a dark patch, but if he's planning something nice for the two of them then maybe things are turning a corner. Two days ago, he had asked John about wedding venue preferences and informed him of the paperwork they'd need done, but he hadn't done this with much enthusiasm. Still, researching holidays could be a sign that he has finally regained some of his motivation and initiative, after all. _Maybe whatever bad is going on in that curly head of his is already fading?_

In that case, perhaps it's best that John doesn't corner him about it.

He doesn't close the lid of the laptop or move the notebook away from underneath Sherlock's hand so that he won't worry about John finding out what he was doing. He does grab an afghan and spread it on his fiancé after noticing his bare arms are in goose bumps; he's wearing only the dress shirt he'd left home in yesterday, with the sleeves rolled up. He looks exhausted, and John realises he's lost enough weight for it to be noticeable.  
  


  
-o-0-o-0-o-0-o-0-o-0-o-

 

A week later, John comes home to find a bottle of champagne on ice on the coffee table with two glasses placed next to it. Sherlock sits on the sofa, looking expectant and nervous.

John realises his partner must have been tracking his commute; they had both allowed the _'Find my friends_ ' function on their iPhones. They hadn't carpooled today, because Sherlock's day had consisted of attending a one-day conference on the classification of gliomas at the opposite end of London from King's College. John isn't surprised he hadn't stayed for the conference dinner, since he hates socialising with colleagues.

"What's all this?" John asks, throwing himself down on the sofa next to his fiancé.

John expects Sherlock to open the champagne but instead, he draws a deep breath as though preparing for a grand reveal.

"We have occasionally discussed a potential honeymoon abroad," Sherlock starts, then snaps his mouth shut, scrutinising John sternly to gauge his reaction.

"Yeah." They had been throwing around ideas after their second engagement in Greece, but nothing had really stuck. There was no hurry since they hadn't even set a wedding date. Maybe Sherlock has gone through his posh diving destination bucket list and decided on a suggestion. John doesn't mind those places; who doesn't love a beautiful tropical seaside location? It's just that, on holidays picked based on just the quality of diving, he doesn't get to spend all that much time with Sherlock since he will be on the bottom of the ocean for much of the time. John would prefer a non-diving trip for their honeymoon, but he's flexible—if there's somewhere Sherlock really wants to go, it won't be a problem to relent.

"I have a suggestion."

"So it seems," John teases him. "So, what's it going to be? Palau? The Seychelles again?"

Sherlock reaches down underneath the sofa and produces a thick, heavy-looking folder which he deposits on John's knees. It doesn't look like a travel brochure, and who the hell reads those nowadays, anyway, since all the info can be found online?

John flips open the first page to reveal a printout from the website of a Norwegian medical volunteer organisation detailing an eight-month opening for a surgeon and an anaesthetist at a district hospital in rural Malawi.

Sherlock straightens his spine and leans forward, obviously preparing for a speech. "Most organizations such as Medecin Sans Frontieres won't guarantee they'll place both halves of a couple in the same location. This project is governed by Norsk Luthersk Misjonssamband; it's small and run by a Norwegian couple who live in the area and work at the hospital most of the time. They need someone—two someones—there to cover for their holidays and to share call duties. They have a very good reputation; I spoke to a neurosurgeon from Bergen who has been there twice."

"Just wait a moment––" John closes the folder. "We were talking _honeymoon_ , not work. What's all this? I don't understand––"

"Of course not, because you've not read that package I put together yet."

John opens the cover of the folder again but keeps looking at Sherlock. "I'm sure it's very… comprehensive, but I have to say I'm confused."

"The organisation assured me that we can combine our duties with some leisure time, perhaps go to Tanzania or Botswana, or see the Namib Desert––"

"Let me get this straight. You want to go to _Africa_. To _work_." An incredulous smile creeps onto John's features. " _You_. Of all people."

Sherlock now looks slightly alarmed. He's shoving his fingers between the seat cushions, presumable to keep himself from fidgeting nervously. "While Malawi is among the poorest countries in Africa, it just may be the safest. You will not get shot," Sherlock insists, and taps the folder with his left hand which he has pulled back out from between the cushions. "It's all here."

John leafs through the contents. There are climate charts, printed articles from medical journals on the country's health care system, detailed statistics about epidemics and malaria resistance in the area and recommendations for prophylaxis. Sherlock has, indeed, been frighteningly thorough.

"Let me get this straight. You want us to go to Malawi to work—as our honeymoon?"

"That is the general idea, yes."

He closes the folder. "Sherlock, I don't know how many times I need to reassure you that I don't want to go back to the service or leave the UK; I've had plenty of that sort of excitement for a lifetime. And, you sure as hell don't have to force yourself through something like this for me. I got it out of my system; I'm not going to get annoyed with you or depressed or whatever you're worried about if I don't get to work in a war zone again."

"You're not listening! It's _not_ a war zone, which is why it's a good option."

John puts the folder on the coffee table. "I'm perfectly fine just having a normal holiday."

Sherlock's eyes are fixed on John's knees. "What if _I_ want to go?" he asks quietly.

"Well, it's––I never thought you'd go in for this sort of thing. Why would you ever want to work anywhere else than London or some other Western country? You like it here. Remember when you caught the influenza and woke up with a thirty-nine-degree fever and the only thought in your head was that you needed to go to work? On a Saturday?" John smiles.

Sherlock looks like he either doesn't remember or prefers not to do so.

John rubs the side of his nose and then leans his elbows on his knees. "Look, I probably should have tried harder to raise the subject with you before, but what's been going on with you? I can't help but wonder if this suggestion is just…I don't know, a way to avoid the actual issue. I know what it's like to want to just take a runner when things aren't great. It doesn't work. And, you wanting to escape to some third-world country sounds like a particularly bad idea."

"Why? Why, John? Because I'm a, quote, 'prima donna', because I'm _'one hell of a high-maintenance man_ ', because I can't be expected to cope without someone constantly keeping watch over me and cushioning my way?"

The first is how Anderson has often described Sherlock, the second is something John will forever regret throwing at his partner in the middle of an argument. The third… possibly something Sherlock's brother has said to him?

"No, of course not. I just don't want you to be disappointed because you want one thing and it turns out to be something completely different," John scrambles to defuse the tension.

"I've done a lot of research. I've read accounts by people who have done similar work in that country. I have read reports–––" Sherlock starts rambling a mile a minute.

John holds up a hand. "I don't doubt whether you've looked into it properly. It's just––– it's _you_. Have you talked to Doctor Pichler about this?"

Sherlock's pale eyes narrow and his lips pinch together angrily. "Why would I need to talk to her? To ask for her permission?" He sniffs and crosses his arms.

"Not what I meant," John hastens to correct. "You don't need anyone's permission for anything—except Greg's if you want to take some leave—but I just wondered if it might be useful to ask her opinion on whether this would be a good idea."

Sherlock springs to his feet, thumbs flicking across his other fingertips as he tries to control his anger and anxiety. "She _not_ my therapist, or my psychiatrist! She's not–– _anything_! I simply consult her about various matters!"

John sighs. Sherlock seeing the psychotherapist is a very delicate topic, and he refuses to accept that making semi-regular appointments with such a professional is, for lack of a better word, at least counselling if not therapy. Sherlock insists that it's, quote: ' _nothing but two professionals conversing on topics which happen to pertain to his interactions with others, especially his trainee'_

_He wonders if Sherlock had confided in her about his recent problems. After the afternoon when John had found him sleeping next to his travel research, things hadn't improved all that much. Sherlock still seemed drained of energy. Lethargic. Uninterested in his research projects. At work, instead of being his usual abrasive self, he has remained fatalistic and withdrawn. Instead of fighting tooth and nail for the way he thinks things should be done, he lets things slide. John has meant to try to talk to him about it once again, but Sherlock has beaten him to it, caught him by surprise tonight._

__

"Can you at least try to explain, love?" John asks. "Where is this all coming from?"

Sherlock slumps down on the sofa beside him. "You left London—once, twice, because you needed a change, needed to be reminded that London isn't all there is," Sherlock tells him. "You're not the only one frustrated with the bureaucracy and limitations of our jobs. I do enjoy the working environment at King's in terms of the physical conditions and available resources and trained staff, but the way things are developing means that surgical specialties are becoming narrower and narrower. Soon, we'll have surgeons who can only operate on the _left_ kidney and are completely clueless about anything else. Don't get me wrong; I have not lost my appetite for the central nervous system, but I hate to think how limited my expertise is when it comes to the entire field of surgery. I don't feel like a _surgeon_ , I feel like someone who spends their days doing the same things over and over again. I'm beginning to understand why you felt as though there was more to anaesthesia than is found in the Western world. We've lost the freedom to innovate, to improvise, to take risks, because we are demanded perfection at the cost of a risk of litigation. I have never been overwhelmed by the nature of my work or its intensity—what overwhelms me is the culture I must perform it in."

It makes sense to John, on many levels. It also explains how Sherlock had been able to defy all his expectations by throwing himself into helping out with patient work at the Camp Bastion hospital on top of overseeing John's convalescence there. He thrives in high-stakes situations; when his work is at its most intense and most demanding, it seems to sharpen his senses and his focus. It's the dealing with the social minefield of a large workplace that exhausts him.

Still, John would not have expected this. Not in a million years.

"But… even if we do something like this, why not have a separate honeymoon trip?"

"Honestly, John. Do you think they'll grant us time off for both? A honeymoon is something they don't have the nerve to say no to. A months-long sabbatical is something they are in no way obligated to grant us otherwise."

It does make sense. There are queues to neurosurgical procedures, and with two neuroanaesthetists on maternity leave, John has had to step in to help with clinical duties on the side of handling his managerial job. This is not the time to request leave, but then again it _never_ is.

"Oh, that reminds me," Sherlock starts.

"What reminds you?"

" _Honeymoon_ , John, do keep up! I solved our ring problem."

"We have a…ring problem?" John is not keeping up at all.

"Yes, of course. Namely, not being able to wear them in the OR. So, tattoos."

"Tattoos," John parrots, baffled.

"We shall have each other's names and our wedding date tattooed as a running text around our ring fingers. It's perfect, John."

John chuckles. "Alright. If that's what you want."

"Well also have _proper_ rings, of course," Sherlock announces. "For when we're off duty."

John is slightly surprised at how much this seems to matter to Sherlock before he remembers how upset he'd turned out to be about the fact that John had stopped wearing his engagement ring for practical reasons. As much as Sherlock scoffs at what he sees as romantic nonsense, he isn't immune to such sentiment at all.

John loves how his partner never stops taking him by surprise and amazing him. "So, we're planning a wedding and a sabbatical?"

Sherlock's reply is a relieved grin and John suddenly has the jolting realisation that he hasn't seen all that many smiles from his fiancé for a while. Seeing the contrast between now and the past few weeks is startling. Sherlock has been upset and in a low mood, and John probably hasn't been paying enough attention to that; they've both been so busy. Sherlock's ennui about work is big news for John—he has never voiced such profound dissatisfaction for it before.

John rises from his armchair and goes to sit next to Sherlock on the sofa, sliding an arm around his waist. "How long would this trip be?"

"Admittedly, my initial motivation was to find a short-term thing we could do in case I found myself frustrated or bored or too inconvenienced by it to continue beyond, say, a month, but the more I thought on this Norwegian-run project, the more it began to entice. We won't be walking into a war zone but the country is poor, and our pay will be ridiculously bad, and the hospital is often lacking even the most basic supplies. Still, the surgeon residing there insists that the living conditions are good and domestic help provided for. It's the perfect time to go—Alice will have left for her consultant post in Johannesburg and the new wing will be done, leaving you with no ongoing major development projects. Besides, you are clearly getting stressed again."

"Me?" John chuckles. While it's true enough that his job does not offer relief from stress, clearly Sherlock has had the short end of the stick lately. "Did you look what The Red Cross and other big organisations had to offer?" John has never heard of this project and why would he have? Neither of them has been very well networked with Norwegian charities prior to this. Trust Sherlock to find such an obscure thing.

"I did. Like I said, they do not usually guarantee joint assignments for spouses, and many of them are quite meticulous in their training and interview processes. I feared you might be rejected based on your past PTSD and I for, well… They require statements from current colleagues, psychological testing, practical teamwork assessments, that sort of thing and I…" Sherlock stammers to a halt.

John can easily glean what he's trying to say: that he's convinced he'd be rejected because of his autism. There's no way around it: it's a big reason why this whole idea worries John, too. "I'm still a bit worried that you're just doing this for me. And that you're going to hate it."

Indignation takes over Sherlock's expression. "I'm doing this for me, not just you. To see if I can do it. To help me believe I can."

John takes his hand and runs his thumb across the knuckles. "You're right—this doesn't sound like the more extreme things that MSF and the Red Cross doctors for. It's still a developing country, though, and not limited to neurosurgery."

"I haven't forgotten what I learned at medical college and after graduation. As for expanding my surgical repertoire, that would be one of my goals, not a downside."

Sherlock is getting defensive, now, and John realises he has to salvage the conversation. "After seeing you in Afghanistan, I don't doubt for a second whether you could do this. Not for a _second_ ," he tells his partner, emphasizing his statement with his lips pressed gently to the inside of Sherlock's wrist.

He is lying, but only a little. If Sherlock needs him to give him this chance, to believe in him, then isn't that John's duty? "The question is, would you like it, or would you absolutely loathe it?"

"There's only one way to find out. You couldn't have known that beforehand about the army."

John places the heavy folder on the table and begins studying its contents more thoroughly. It won't be easy, that much is clear: reports on the problems of the local healthcare system are dire, and John worries whether he is simply swapping one batch of hair-pullingly frustrating bureaucratic issues for another set of infrastructure problems. But, he realises that, instead of being at the mercy of the NHS machinery, they would be _running_ a small hospital, just the two of them, when the other two doctors are not on duty. They will call the shots. Together. Something about that had feels oddly irresistible.

This is a crazy idea. An entirely unexpected idea. They might not even be allowed that much time off work from King's College. Sherlock might hate it. Hell, _John_ who has been abroad in tough spots before, might hate it.

Or, it just might be the most amazing thing they would ever do together.

At the end of the folder is a colour photograph Sherlock must have printed out at work since their home printer only has black ink. Labeled _'Malosa Mountain Range, Zomba District, Malawi_ ', it shows a steep vista of sharp mountains shrouded in bluish mist cradling bright green grasslands. In the far distance, a blue lake glistens and clouds hang low around the peaks. Everything looks brighter, wilder and so much more interesting than the grey, rainy London twilight outside their sitting room window.

John looks up from the photo. "You better pop open that bottle," he tells Sherlock.

The grin instantly spreading on his soon-to-be-husband's face is infectious.  
  
  
  
  



	4. Husbands

 

>    
>    
>  _If you have, give; if you need, seek._  
>  — Malawian proverb  
> 

The reception is quaint; only thirty guests receive them at their cordoned-off private table at the Landmark Hotel's Winter Garden restaurant after they'd made their vows at the registry office with Harry, Sherlock's parents, and Mycroft as their witnesses. Planning for Malawi had so taken over their time that the wedding seems like a side note; neither of them has ever dreamt of a big celebration, and for both the day mostly just confirms what they've known for years—that they want to spend the rest of their life together.

That doesn't mean they don't both break into tears at some point during the proceedings. Sherlock blames the champagne for it, and John blames Sherlock.

The first wobbly moment for John had undoubtedly been at the registry office when Sherlock had revealed the music choice he'd carefully concealed beforehand to be a violin performance of Elgar's _Salut D'Amour_ he'd recorded himself without piano accompaniment. Cheeks tinged with red, he'd told John that he had meant to play live, but even just recording the piece at home with borrowed equipment had turned out to be almost too nerve-racking. _'I can't stand the most commonly used wedding marches_ ,' he'd explained; _'They're so filled with overly romantic saccharine cliché_.' There had been nothing cliché about his Elgar, but John had refrained from teasing him about the fact that it is still a profoundly romantic piece.

Sherlock had chosen his boss as his best man, and at the reception, Lestrade delivers a hilarious speech detailing their relationship from the point-of-view of someone for whom _'it has been quite a wild spectator sport_ ', as the older neurosurgeon puts it. "Sherlock has proven that it is possible to be an insufferable twat _and_ blissfully happy in love at the same time," he concludes his explanation of the early days, and John has tears in his eyes again for laughing so hard. He keeps stealing glances at his freshly minted husband to see if the gentle humour is pricking the man a bit too hard, but since John gets his fair share of jabs, too, it all seems to go down well.

Harry is John's _best person_ , as he had put it when asking her to fulfil the role. She's been sober since Scotland and is trying her damnedest to hold on to a job keeping the inventory of a large grocery store. She used to moonlight as a bartender but has decided that it's too big a risk to her abstinence, now. As an extra wedding present, she passes Sherlock an envelope with a hundred-pound note inside. "The first of my loan payments." She doesn't make a speech; she has not been very involved or present in John's life during the time he's been together with Sherlock.

Mycroft Holmes, however, visibly enjoys taking over the stage. His speech is precisely what one might expect—dry, politically correct, contains just the requisite amount of bland and inoffensive anecdotes from his and Sherlock's childhood, and a toast at the end wishing for happiness and financial stability for the couple. Sherlock raises his with an artful enough eye roll that it makes John snicker.

"I'm surprised he didn't add _fiscal responsibility for the selection of investments and sustained erectile ability despite advanced age_ ," Sherlock whispers, and John bursts out laughing, spilling a bit of Armand de Brignac on his morning coat. Being the more sartorially inclined of the two, Sherlock had planned their outfits. Gieves & Hawkes peak lapel morning dress with an ivory plastron, understated gold waistcoat, houndstooth trousers instead of the traditional striped pattern, and boutonnieres based on a white rose and a bit of green. John had briefly considered wearing his parade uniform, but it just hadn't felt right, somehow, even though Sherlock had seemed amusingly keen on the idea.

"That part of my life is over," John had told him. "I'm more a doctor, now, than I am a soldier, and I'm not going to wear scrubs or a white coat to the ceremony, either. This is about _us_ , not about Mister Holmes and Doctor and Captain Watson."

Last names are a non-issue; they've both decided to keep their own. "Holmes-Watson is a bit of mouthful," Sherlock had concluded one evening, lounging on the sitting room sofa in just his pants and his blue dressing gown.

"Watson-Holmes isn't any better, is it?" John had replied and plonked two steaming mugs of tea on the coffee table.

They haven't booked a hotel room to go to after the short reception—instead, they return to their box-filled Brompton flat so that they can continue emptying it first thing in the morning since there's only a week to their departure.

Their belongings will go to a storage facility. Their landlord is not happy to lose his long-term tenants but still sends them off with well-wishes and a farewell dinner at his country club. Eight months does not sound _that_ long a time, and their rent had been very reasonable, but it is still pointless wasting money on it for the duration. Mycroft has offered them the use of his townhouse in Mayfair after they returned so that they could take their time flat-hunting. John hasn't even seen his brother-in-law's recently renovated London residence yet, but Sherlock has assured him that it's "As cold as his soul; he thinks interior decoration means drowning everything in marble and framed pictures of pompous farts from the history of the empire".

The most significant negotiations needed to enable them to travelve happened at work. It has taken quite a lot planning and delegation of duties before John can be released from his myriad administrative duties for over half a year. Lestrade has helped dramatically in putting pressure on the right people up the ladder, and John suspects that Sherlock has used the fact that King's doesn't want to lose their star neurosurgeon as a bargaining chip. To seal the deal, John had promised to write a few articles on their experiences for the staff newsletter and for the Trust's website to demonstrate how ' _international collaboration is one of the Trust's highest-regarded values'_. These were the words of one member of the board to whom John and Sherlock had to bow down to get their leave of absence.

One part of their preparations has extended Sherlock's working hours to the breaking point: a few months before they were due to leave, he began spending every moment he could spare visiting other operative departments. Gynaecology and obstetrics had been the one where he put in the most hours; he had asked Jens-Erik, the gastric surgeon living full-time at Malosa how he should prepare, and the man's advice had been simple: _'learn to do a Caesarian section, they are the most common operation we do here_ '. It was also an area of anatomy particularly far removed from Sherlock's own field of expertise; the other common stuff, such as inguinal hernias, fractures, boils and appendectomies, he had done a fair share of during his basic surgical training. Operative gynaecology and obstetrics would be a completely new area to conquer. John had delivered a few babies earlier in his career, but he'd be too busy doing the anaesthetics to be of much help at the other end of the table.

He's done some of his own research to prepare; the conditions at Camp Bastion had been much more modern and well-supplied than what he will encounter at Malosa. On a good day, spinal needles and a working patient monitor might be available. On a bad day, the failing electrical grid will not even power a pulse oximeter, and the staff has to rely on battery-powered stuff and ketamine to get by regardless of what sort of surgery and what kind of a patient is on the table. John has contacted as many London hospitals and charitable foundations as he has had time for to amass some outdated, free-of-charge supplies to be sent to Malosa, but his loot is not very impressive since most were already sending stuff out to large international organisations.

One thing John does not worry about was their teamwork. They have already faced so many crises and challenges together in theatre. Their co-operation has been honed to near perfection in the OR, and John likes nothing better than to get to handle one of Sherlock's urgent surgeries during call at King's. This will merely be a new set of challenges they could take on together, and he is looking forward to it.

As he stands outside the front entrance of the Landmark Hotel, waiting for Sherlock to escape the clutches of some female Holmes relatives wanting to squeeze the life out of him for good luck, John spots a familiar figure walking towards him. Even the ever-reserved Mycroft Holmes has been all smiles as the evening progressed, and the subtle, glassy look in his eyes betrays that he has enjoyed his after-dinner whisky.

"I must say," he starts, "That I did not anticipate this day ever to arrive." He glances behind his back to where Sherlock is buttoning up his coat inside the doorway, still out of earshot. "My brother has never been what one would call a happy person. For long, I believed that to be a combination of personality—whatever dictates its shape—a clash between his needs and our upbringing, and genes. After you entered his life, I've been forced to re-evaluate my assessment. Now, I think, his misfortunate has been borne mostly out of circumstance—of loneliness, incompatibility with most of humanity, and painfully advanced intelligence. I say painfully because it gives him a grating awareness of the chasm between him and most people. I am pleased that he has found someone with whom he has been able to maintain a relationship."

"It takes two," John reminds his now brother-in-law. "We both had to put in the work."

Sherlock joins then, eyes narrowing as he takes in the sight of his brother rocking back on his heels. "Come to offer your advice for the wedding night, Mycroft? I assure you, I have amassed several years' worth of knowledge regarding what to expect."

Mycroft Holmes splutters silently in a well-bred manner, then retreats with a courteous nod.

"Prat," John tells his husband as they take up a position by the kerb to hail a taxi.

" _Your_ prat-in-law," Sherlock reminds him with a smirk.

-o-0-o-0-o-0-o-0-o-0-o-

  
"Not packing your violin? Eight months is a long time."

"I worry about the humidity, and I've heard horror stories about staff insisting on shoving a violin case into the hand luggage compartment without any regard to the sensitivity of its contents. Mycroft has promised to look after it while we travel. It'll be stored at his townhouse."

"Can't he store our other stuff as well, then? He's got the space."

"I'd prefer not to owe him _that_ big a favour."

John frowns. "How valuable is that thing, really? You've never told me. Since you're not a professional, I assumed that it's… what's a normal price range for a violin, anyway, for someone like you?"

"Someone who can play?"

John nods.

"It's a family heirloom."

"O-kay. Expensive, then."

"Separately insured. Mummy pays the fees since it's from her side of the family. It was built by Charles François Gand."

"Not Stradivarius, then," John jokes and pretends to wipe sweat off his brow. "Phew. I'd have worried if something like that was––

"It's from the early nineteenth century France, and auction prices vary between twenty thousand and fifty thousand pounds."

John's eyes go wide. "Christ. Yeah, maybe we don't shove that in the luggage compartment, or risk it being eaten by termites in Malawi."

 

-o-0-o-0-o-0-o-0-o-0-o-

  
Heathrow.

Noise mixes with stale air circulated through too many lungs, and the nervous tension on their fellow travellers' features flirts with exhaustion and anticipation. Sherlock wastes no time in beelining for the Plaza Premium Lounge, to which he has access through his Platinum Amex. John hasn't bothered with loyalty programs or such cards, and he hardly needs to when it comes to airport lounges since Sherlock can bring him in as a guest.

The offerings of the buffet pass the muster of the finicky neurosurgeon, and they take over a small couch in the corner of the main floor. There are two hours to go before their first flight which will take them to Nairobi on British Airways. There, they'll swap to Kenyan Airways bound for Lilongwe, the Malawi capital. From there, a small propeller plane will transport them to the tiny airfield in Malosa.

John treats himself to a whiskywhile Sherlock fires off some emails from his tablet pertaining to his research projects. They will probably have to be put on hold for the duration of their trip; John had swallowed hard when he had read the email which had arrived a week ago, explaining the hours the hospital's regular doctors usually put in. When John and Sherlock are there, each pair of doctors will work for a week, then get a week off, and when the other two physicians go back to Norway for a holiday, John and Sherlock will essentially have to make themselves available non-stop. When it's quiet, they can be at home at night and in the evenings, but they might get called in at any time if there's a crisis that can't wait. No weekends off, and nobody's counting overtime. ' _It is what it is_ ', Åse Haugland, the anaesthetist, had written; _'you'll get used to it_ '.

Sherlock had seemed unfazed by this news. He appears almost stubbornly determined that nothing is too much, nothing is alarming, everything will work out. It's John's job to be the realist with some actual experience of working somewhere else than the UK.

"They're _old_ , John. If they can do it, we can do it," Sherlock had announced after reading the email over John's shoulder.

"They do it because there's no option. There are some of these so-called medical officers in the hospital, but they only have a few years' training and are no replacement for a doctor. Some of the nurses have been taught to administer spinals and intramuscular ketamine as anaesthesia for surgeries, and one of the officers knows how to do a C-section. But, that's it when it comes to surgery. If we don't go in when someone needs it, they will go without. Can you live with that decision?"

"Without the Norsk Luthersk Missionssamband sponsoring the hospital, they'd probably have no trained surgeons at all," Sherlock argued.

"I know you," John countered, mildly amused at Sherlock trying to pronounce Norwegian before his expression sobers up again. "I'm worried you'll go above and beyond human endurance when there's work, and I have to be the one to set limits."

"Isn't that how it works here, too? How is that new?"

Sherlock made it sound so damned normal as if it was alright that John had to make sure that his competent, educated, adult husband sometimes slept and ate and relaxed and didn't work himself into an early grave.

"You need to put on the oxygen mask on yourself before you help others," John quotes Molly Hooper, his therapist from after Afghanistan. A doctor who cannot function can't help anybody else.

"Why are you quoting aeroplane safety demonstrations?" Sherlock looked flummoxed.

"Maybe this'll be a good lesson in looking after yourself, that's all."

"You mean become a slave to the whims of my Transport like everybody else?"

"Your _what_?" John was pretty sure he remembered hearing Sherlock using the term before, but he's not paid much attention to it.

Sherlock waved his hands down along his torso. "The _Transport_ , John; the receptacle for our brains."

"It's called the human body, and you of all people should know how complicated and fantastic it is and that it can break down if it isn't looked after."

"The central nervous system is all that matters; the rest is just a support system for it and essentially pointless in and of itself."

John raised a sly brow. "Essentially pointless, huh? It sure is a nice-looking––" he stood up from behind the desk in the guest room and turned so that he could wrap his hands around Sherlock's waist and tug him close. "––support system with some interesting features. Could I interest it in some utterly pointless orgasms?"

Perhaps the only situation in which Sherlock serves his Transport to a T is when he flies. He'll accept Economy class only for short flights; otherwise, he'll gladly pay for both their tickets if that gets them into business or first. Thanks to holidays and frequent conference trips, he racks up enough miles to get upgrades on the cheap. On board, his tactics for maximising comfort and minimising intrusive sounds and visuals are myriad. Once, they had been forced to check their hand luggage last minute for an eleven-hour flight, depriving Sherlock of all his gear, and John never wants to repeat the experience for both their sakes. By the end of the flight, Sherlock had been upset, waspish, so over-sensitised and overwhelmed and he'd minced his words and covered his face with his palms trying to drown out the noise in the terminal, shaking as they queued up to passport control. Once they got their bags, he had locked himself into a cubicle of a toilet in a quiet corner of Singapore's Changi Airport until he had calmed down. Once they got to their hotel, he slept around the clock.

Just as John is getting rather bored just sitting around in the lounge, their flight begins boarding. Once they've found their seats, Sherlock begins his preparations. Since all John requires for a bearable flight is a functioning entertainment system and a bottle of water, he watches his now-husband settle into the fully reclining seat across the aisle. Out comes his own pair of state-of-the-art dynamic passive-active noise-cancelling headphones—British Airways offers a low-end pair for all Business class customers, and those Sherlock just shoves into the hands of a stewardess. Out of his bag also come a gel mask for sleeping, hand cream, and a cashmere wrap. Instead of his usual suit, he's wearing black jeans which are a slightly bigger size than he usually wears, and John likes the way they hang on his hips with the belt loosened. He's got a long-sleeved T-shirt under a soft cotton dress shirt, and to John it all makes him look a bit younger; like a uni students flying home for the holidays.

John thinks back to the military flight Sherlock had taken from Brize Norton to Kabul. He hadn't had time to go home to pack anything; from the hospital, he'd gone straight to the army airfield, according to Mycroft. There had been no cashmere wrap, no headphones then, no comforts at all. What had it been like for Sherlock, landing in Kabul and then having to wait for a helicopter flight at night to Camp Bastion? Had there been combat that night in areas they flew over?

Sherlock had told him he hadn't even been certain that John had survived the first hours after getting shot. He hadn't even known whether he was travelling to help his partner, or to bring him home in a casket.

 _Never forget what he did in Afghanistan, and how well he did it_ , John reminds himself to squash the worry that had raised its head as he watched Sherlock being, well, very _Sherlock_ with his preparations for being stuck for ten hours in an aeroplane. _Let him enjoy a bit of luxury now before we leave it all behind_.

  
-o-0-o-0-o-0-o-0-o-0-o-

 

The international airport in Lilongwe feels familiar enough, in the way that airports around the world are always the same: bland, similar, without much local colour. As they sit in the depressingly concrete-dominated transit hall waiting for their connecting flight to Malosa, John is deep in thought. All practical arrangements had been finished with an excellent time margin, all the bureaucratic hoops jumped through with the expert help of the Norwegian doctors residing in the area, but there is one thing left that John is worried about. One could say that it is the elephant in the room: the nature of their relationship in a country where sexual minorities are still persecuted. John had put off looking into this, but last week he'd sat down and read everything he could find online.

He had learned that, in 2012, President Joyce Banda had announced an ‘intent’ to repeal laws criminalising same-sex relations and had in the interim suspended the execution of all laws that criminalised homosexuality. But, the issue remained complicated, and in 2015 a new Marriage, Divorce, and Family Relations Law came into force which, while bringing on the much-needed improvement of raising the minimum age of heterosexual marriages from sixteen to eighteen, banned all same-sex marriages and unions, drew comparisons between sexual abuse and gay sex, and did not recognise gender correction. The Malawi Constitution's anti-discrimination statutes could be interpreted as banning discrimination against sexual minorities, but there has been no specific legal ruling to that effect. The international community continues to pressure Malawi into changing its ways, and Western countries have, on occasion, even suspended humanitarian aid to the country based on the way its government continues to allow and even cultivate an environment conducive to discrimination on the basis of sexual orientation and behaviour.

If that is the uncomfortable theory, John wonders about the practice on the ground. The Norwegians expecting them are the only two doctors in permanent residence. Jens-Erik is a general surgeon who had done a second speciality as a gastric surgeon and worked in Norway all his life until retirement. He'd met his wife, Åse, at a conference a year before she'd retired; she was a good ten years older than him. Åse had spent twenty years working for WHO and various other international NGOs; she'd left Norway right after reaching consultancy in public health. Like John and Sherlock, they had initially signed up for an eight-month stint at Malosa—and stayed, eventually getting married.

During one of the first phone conversations between Jen-Erik and himself, John had raised the subject of their relationship.

"What you read in reports and newspaper is one side of the truth, John—it _is_ the truth, but it doesn't say everything there is to say about individual people here. I would advise against being very up-front about it with other people, but keeping that in mind, I doubt you will have any problems. Physical affection between men, friends who are men, is common; sometimes Westerners falsely assume that two locals are a same-sex couple if they don't realise this. It will make sense to the locals that since you are two doctors working here for the same time period, you would share a house."

"What about our housekeeper? Should we have to use two bedrooms?"

Jens had erupted into a belly-deep laugh. "Louisa, your housekeeper, will know; even if you don't tell her, she'll know because that's what she's like—she knew about Åse and me before _we_ knew about us. I assure you that she will not find it problematic. She's seen all kinds, and she is an old woman with common sense and tolerance. When you meet her, you will understand what I mean. There are gay people here, John; they just cannot be so open about it."

Sherlock's face is hidden behind The Times; John pushes down the page. "Who knows that we're a couple? You haven't mentioned it in any of our applications or official papers, have you?"

Sherlock had everything filled in and ready to be submitted by the time he brought his proposition to John.

"Our applications reflect reality: that we are both married, and our spousal contact information is correct."

John opens the lid of the chocolate pudding he has just bought from a small shop in the airport; not his favourite, but the selection had been slim. "Malawi doesn't acknowledge gay marriage."

"The Minister of Health assured me it's a non-issue when I spoke to him on the phone. A British marriage certificate will be respected."

John accidentally inhales a piece of the pudding, leading to a coughing fit violent enough to warrant raised brows from an Etihad stewardess dragging her trolley past them. "You asked the bloody Minister of Health _that_?!"

"Despite the country's despicable laws, he was quite accommodating due to the nature of our professional expertise. There is only one cardiologist in the whole of the country. Care to have a guess at how few surgeons there are in Malawi in general, even after the Blantyre–Oslo initiative have brought in some paediatric and neurosurgical expertise?"

"Even if the Minister of Health is not against LGBT rights, we still don't want to, you know, _flaunt it_."

"Flaunt what? Our overwhelming, flamboyantly pervasive gayness in everything we do, including the rainbow flag we will land wrapped in? Sorry, I should correct to ensure full inclusivity: gayness slash bisexuality?" The corner of his lip is tugging up.

John sighs and shakes his head. For Sherlock, his sexuality has never seemed to pose much of an issue with other people, but John has discerned that the reason might be a depressing one: people tend to take a knee-jerk dislike to him for other reasons, making the fact that he belongs to a sexual minority a margin note.

For John, it's been much more a struggle to accept being bi. And now, they're heading into a country where a law still says that two men could be imprisoned for over a decade for having sex, even if that law is not being actively executed. "I just hope it's not going to be an issue."

"Well, if it is, then I will undoubtedly bear the brunt of it. You blend in much better."

"Blend in? With the straights?" John rolls his eyes. "Sherlock, we're not going to blend in—we're the wrong colour, to start with."

"Precisely. That is a big enough difference to focus on that they might not even notice anything else. In the cities, there are plenty of Europeans, but we'll be in the countryside where the balance is much different. We will invariably do things differently, and eventually go back to our home country, so I assume some wiggling room will be allowed."

They have travelled to countries before where homosexuality is not legal or even persecuted, but those have been holidays where they've stayed in the Westerner havens provided by luxury resorts and boutique hotels.

"Didn't you talk to Jens about this, already? He should be able to predict what to expect," Sherlock asks.

"He wouldn't be, and you know it because he wouldn't have had the experience we're about to dive into."

"You're such a catastrophizer."

"This is kind of important."

"And we're already here, so all we can do is go forth and go see what happens."

 _He's right_ , John thinks. _It is kind of too late to worry about this, now_.

 

-o-0-o-0-o-0-o-0-o-0-o-  


The reality of their undertaking finally begins to kick in proper as their six-seat plane leaves behind the capital region and heads out into the wilderness over the Dedza-Salima Forest Reserve. Low, rolling hills begin curling into higher mountains in the distance, there are no paved roads anywhere in sight, and grasslands extend as far as the eye can see.

Sherlock's hand seeks out John's as they looked out into what will be their temporary home. Though he conceals it well aside from the sudden hand-holding, John suspects that Sherlock is getting nervous, having never lived or worked outside the UK. He'd held his own—held them _both_ together in Afghanistan—but this time, John swears that he won't have to adjust to the alien environment alone. This, they will do together. He's going to look after Sherlock; not because the man needs mollycoddling, but because John wants to. He just needs to find a way to do it without undermining his husband's confidence.

  
  
 


	5. Strangers in A Strange Land

   
  


> _One must come out of one's house to begin learning._  
>  —Malawian proverb  
>    
>    
> 

After their small plane touches down at twilight on the small airfield on the outskirts of Malosa, a local middle-aged man walks up to them and offers John his hand to shake. They had been told that the hospital's janitor would give them a lift from the airfield and true enough, he leads the two doctors to a beat-up jeep with the hospital's name—St Mary's—painted on the side. He doesn't seem to speak a word of English and Sherlock seems a bit hesitant to climb into the backseat, but, by the time they get all their bags loaded to the back, all the other passengers and the staff have left the field, so this must be the right transport.

Sherlock is quiet as they drive past mudbrick houses, cow pens, and women walking with large water containers perched on their heads. Children wave as they drive by, and birds screech as they take to flight from the reeds beside the road. Judging by a few puddles, there's been rain; the landscape is bright and green, and the air smells of ozone and earth.

"You okay?" John asks, and grabs Sherlock's hand, giving it a brief squeeze.

Sherlock frowns at the gesture, glancing towards their driver who is paying no attention to what's going on in the backseat, then nods. "It's beautiful out here," he says, just loud enough to be heard over the engine noise. He then turns away from John, presumably to watch the sun set behind the mountains.

Together, they've travelled to plenty of tropical locations, but they've never been anywhere this remote, this rural. John tends to let Sherlock plan their trips, and that usually leads to luxurious accommodations. Even when doing something more adventurous, they tend to stay in places that offer Western-style dining, impeccable hygiene, Western bathrooms, and safety from insects and inconvenience. A lot of the luxury, to John, feels impersonal and paint-by-numbers; inside the resort complexes, one could barely even deduce the country.

Malawi will be very different.

John doesn't want to think his partner is spoiled or incapable of flexibility and common sense, but he knows how taxing it is for Sherlock when he has to adapt to distracting noise, irritating textures, or strange food, especially when exhausted and stressed out. _The first few days here will be a challenge._

As cicadas begin a nightly serenade, and fatigue has thoroughly replaced excitement, the car stops in front of their new colleagues' spacious brick house on the outskirts of Malosa. Their own residence, a smaller house a mile away, is still being cleaned and prepared, which does not bother John. The thought of staying with someone at first seems reassuring since it might help them find their bearings.

Åse Haugland, the Norwegian anaesthetist-slash-generalist whose images John has seen in several articles and on his laptop Skype window, stands on the front porch, waiting for them. She is wrapped in a colourful shawl and wearing a white linen dress; probably not her work clothes, then. She has long, greying brown hair and deeply etched laugh lines on her face. Age has treated her well.

The janitor helps the two men lift their bags off the back of the car, after which Åse exchanges a few words in the local language with him before he drives off into the night. She then wraps her shawl tighter around her and descends the steps to give John a tight hug. Sherlock instinctively retreats and shifts the bag he's holding to act as a shield in front of him—he is not a hugger.

Åse does not care. In a manner John wouldn't have expected from the usually reserved Scandinavians, she grabs the bag from Sherlock, puts it on the first step, then envelops the man in a crushing embrace complete with a kiss on the cheek which he rubs off as soon as she lets go.

John can't help a bit of laughter bubbling up; undoubtedly Sherlock will have to get used to the locals being a lot less reserved in their greetings than their fellow countrymen in London tend to be.

"Evening," Sherlock offers warily.

Åse grabs two bags—despite her diminutive size she is obviously strong—and starts hurrying towards the front door. "Come on, come on, Jens is setting the table!"

She leads John and Sherlock to a spacious dining room in the middle of the house. Jens-Erik, a tanned wiry man who looks a decade younger than his years, offers them both a firm handshake after lighting some candles. He's a wiry man with a partial facial paralysis affected his lip. It had been caused by a stroke he'd suffered a decade ago, but from which he has otherwise recovered perfectly. He introduces their housekeeper Tiwonge; a woman John estimates being in her thirties, wearing a red headscarf. There's a small boy hiding behind her back.

"This Dumi," the woman points at the boy, who crawls under her long skirt giggles at being mentioned.

Åse thanks her for the dinner arrangements, after which she, the child in tow, heads home. "She has eight children," Åse tells her guests. "Dumi is the youngest."

Jens-Erik directs John and Sherlock to get seated at the table, and John breathes a sigh of relief on behalf of Sherlock: what's on offer is recognisable: chicken in a rich, yellow sauce with vegetables, rice, flatbread, and a green salad.

Åse flicks away a small, colourful beetle than lands on the table and takes a seat before pouring everyone water from a pitched.

"It's bottled," Åse says. "We'll help you order bigger tanks of it from the shop. Better get used to making sure you've always got plenty of bottled in the house; don't even brush your teeth with what comes out of the tap unless you've boiled it. Please tell me you've got your malaria prophylaxis sorted?"

John assures her they are both on an atovaquone-proguanil combination. John had first considered doxycyclin, but Sherlock had reminded him how very prone he is to getting sunburnt with his pale complexion, even without a drug that would render him exceptionally susceptible to ultraviolet rays.

Jens-Erik tells them that a young Swedish doctor had nearly walked a cliff two years ago on his first evening at Malosa when exhaustion had pushed him into a mefloquine-provoked psychosis. This is why the resident doctors have taken to recommending a newer combination drug to arriving employees. They'd had to send the Swede home immediately, which meant that they'd had no relief staff for a holiday that year. Åse explains that, apart from an American gynaecologist who comes every winter to work for two months, they are the only doctors in the hospital. All other medical care is provided by nurses and locals trained as so-called Medical Officers. Lasting two to three years, the training naturally doesn't come anywhere close to matching that of a European doctor. Nurses are always at short supply, so family members of patients pick up the slack of bathing, feeding, and providing for other basic needs of patients.

John asks them some questions about the practicalities such as grocery shopping, banking and internet, while Sherlock picks silently at his food and fidgets on his chair. John knows how to interpret the signs: his newly wedded husband is exhausted and overwhelmed, possibly to the extent that it'll be difficult to get him to sleep. He hopes their hosts won't talk to Sherlock much; the answers they'll get are unlikely to be polite at this point.

"I read your latest paper in Lancet," Jens-Erik comments, pointing his fork momentarily at Sherlock. "Very impressive."

"Thank you. You have also published some work in passable journals," Sherlock counters.

Jens laughs. "I suppose you could say that. I was the head of gastric surgery at Ullevål for twenty years."

Åse chases down a piece of bread with water before nodding towards her husband. "He did the first bariatric operations ever done in Norway."

"Gastric band?" Sherlock asks. He seems to perk up at least a little, thanks to the conversation turning to surgery.

"Biliopancreatic diversion, bands, and gastric bypass. We tried it all."

John's brows are knitted together. "How do you feel, working here and seeing malnutrition and other such things after helping obese Norwegians lose weight?"

"It doesn't make me angry at Norwegians," Jens replies with his soft, strongly accented but easily understandable English. "Any country that had the oil Norway has and was as industrialised and Westernised would have the same health issues. No, seeing the difference between the countries actually makes me angriest at Malawi politicians for their corruption and bad decision-making. History is what it is, and much of the reasons why Africa lags behind in development is of course due to the legacy of imperialism and not being able to prosper from their natural resources. But, the government could be doing a lot more to strive forward. The Western world should be helping this country, but it will all be for nought as long as so much money belonging to public services is just fattening up the pockets of high officials and politicians. But, God willing, Malawi may one day have its first need for gastric bypass. Let's hope they develop wiser than Norway."

John raises his glass of water. "I'll drink to that."

They clink glasses together.

Jens and Åse don't ask John and Sherlock why they've chosen to come here, because those conversations have already been done on the phone and by email. Åse had told them that before someone actually arrives and works a bit, the two of them can never predict who stays and who quickly returns home with their tail between their legs. The two local doctors had seemed impressed with John's Afghanistan tours and said that a team of a surgeon and an anaesthetist would be perfect for the hospital.

John had done most of the talking when they had Skyped; Sherlock had told him that he worried that his questions might cause confusion and alarm in the Norwegians. John had tried to tell him he had no reason to worry but remembering Sherlock's reasoning for choosing this project instead of applying for something through larger organisations, John understood his reticence. It had still irritated John a little that once the decision was made, Sherlock delegated or deferred to him so much of the practical planning and communications.

Now, the moment of truth has arrived. They're here, and John hopes he's good enough at reading Sherlock to pick up on it if there's anything worrying going on instead of just a normal adjustment period. Sherlock has worked hard to convince John that his motives for coming here are based on professional development and enjoying a bit of a change of scenery, but John knows from his own experience that when wanting to leave London is preceded by things being a bit not good, a person's self-awareness of more sinister motives might not be very good.

_Maybe this is Sherlock's Great Escape. What happens if this doesn't turn out to be what he's looking for, and what happens when we go back to London?_

During moments when John has worried the most about this working holiday, he had been tempted to press Sherlock to talk to Doctor Pichler or contact her himself. Maybe she could have offered some pointers on how to navigate an experience like this with someone like Sherlock. But, it had seemed so important for the man that this was his decision, for which he would take responsibility. Again, John wonders how to manage to help Sherlock without being called out for mollycoddling.

_Or, is my assumption that he'll need help adjusting a bit condescending in itself? I just want him to be happy._

They enjoy a bit of cognac as a nightcap with slices of local fruit. John can't help keeping an eye on Sherlock's eating; he has learned that it's a good gauge to his stress level. He had mostly eaten bread and rice at dinner even though the chicken casserole wasn't all that different from some of the takeaway curries they enjoy on a regular basis.

Every bite of fruit that goes down lowers John's heart rate.

Sherlock doesn't participate in the light conversation. In the middle of it, he rises to his feet and walks out to a balcony behind a screen door to watch large bats catching insects in the light of the lanterns hung from the rafters. Eventually, Åse joins him and soon they're discussing the creatures and some other things living around houses in the area.

 _At least he's not squeamish about bugs or snakes_ , John thinks. As far as he knows, Sherlock is interested in such things, the taxonomy of animals and invertebrates, plant and animal toxins and so on.

Finally, after Jens lovingly berates his wife for keeping their tired guests up for too long, they are shown to the Hauglands' guest room. It has a narrow, old, metal-framed bed, but the mattress is thick and fresh sheets have been put in place. Åse clicks on a fan at the foot of the bed; something inside it is making a tiny rattling sound John just knows Sherlock will hate.

Åse promises them hot water for a shower in the morning; John feels grimy from the flights but is too tired to bother with a wash-up tonight.

At home, Sherlock showers or bathes daily. He doesn't reply to Åse's inquiries and explanations about the hot water, just stands by his unopened suitcase, his gaze wandering around the room. He's picking at something in his sleeve and looks as though he's humming with restless energy even though his eyes are occasionally drifting shut.

After teeth have been washed and clothes removed—it's warm, so they will sleep in just their pants—they crawl into bed, and John pulls the sheet up just like he does at home when they retire for the night. He's surprised when he notices it's two half-size sheets instead of a double-wide one. Then, he remembers that Scandinavians rarely do double duvets or double-wide sheets.

Floorboards creak somewhere in the house, and there's the sound of old pipes spluttering as Åse and Jens see to their evening routines.

Sherlock tugs his sheet up to his shoulder. Even the tiniest movement on the bed causes a metallic creak. John curses inwardly before extending his arm in an invitation for his partner to scoot closer. Sherlock wastes no time in doing just that; he presses his back against John's stomach and drapes his arm across his midriff.

"Everything alright?" John asks quietly, rearranging some of Sherlock's curls since they must be tickling his ear. He closes his eyes momentarily, inhaling the familiar combination of aftershave, sweat, Sherlock's hydrangea-and-sandalwood shampoo, and that elusive essence which could bear no other name than _Sherlock_.

"Why do you keep asking me that?" Sherlock mutters, taking his fist gently to his pillow by his chin to reshape it to his liking.

"It's been a long day."

"The laws of physics dictate that it's been precisely as long for you as it has for me, so should I be asking you the same? Or, is there something in particular about me that you consider a risk factor to not being alright?" His tone is slightly biting. He's challenging John, making a dare.

John realises he needs to shift the focus if he wants to avoid Sherlock adopting his usual hedgehog defence strategy when he feels put on the spot because of how he's different from most people. "I'm tired, I hate this bed, I feel cruddy after the flights and the airports, and I'm a bit worried about what our house and the hospital will be like. On a scale of zero to ten where ten would be absolutely A-okay, I think I'm a six right now."

Sherlock's silence feels thoughtful. "Why do you feel the need to talk about this? It won't change anything."

"Because we're going to be here for quite a long time, and Åse and Jens will be gone for a big chunk of it, so I'm going to be the only one here who has an idea how you feel and why this is sometimes going to be really hard. Talking about it helps, I promise, and I'm going to be the one you need to talk to when it gets tough."

"Did it help in Afghanistan?"

"Admittedly, I wasn't great at it after I got shot, but in general, the other people you're with in weird circumstances are the best thing about it. Experiencing stuff together, sharing things, talking about it, feeling like you're not alone. That's _so_ important; nobody could do it if they didn't have that kind of support. This isn't going to be easy for _either_ of us, love. I'm going to need you to have my back, too."

"So I'm——" Sherlock starts, and John can _hear_ the frown. "––your–––I'm the person you need to talk to…about things. About things you find difficult."

"Yeah. That's kind of what husbands are for?"

"What if I don't know what to do about those things?"

"They're not problems you need to solve. You just need to listen. And be around."

"But you'll––" Sherlock trails out.

When John feels him tense up in his arms, he places a hand on Sherlock's bare, pale, sweaty shoulder. "I'll what?"

"You'll blame me. If I complain."

"Blame you for what?"

"For suggesting this in the first place."

John sits up, thanking his lucky stars that the past years have taught Sherlock enough about the importance of telling him things that they can stick the pin back into this proverbial hand grenade right now.

He tugs Sherlock's shoulder back a little so that he can get his partner to look at him. He can barely make out Sherlock's features in the dark. "I will never say anything like that to you. I might get angry with you at some point, or this place might drive me round the bend, but we decided this together. You suggested it, did the research, and I said yes. Clearly, you'd put a lot of thought into it regarding… well, lots of things, and I have no right to question your ability to do this, especially because it's not going to help when push comes to shove. I will never say _I told you so_ , not even if we decide to call it quits before our eight months are up."

He settles back down on the bed. Sherlock grabs hold of his hand and kisses his knuckles. They lie together in the darkness, the noisy fan accompanying their deepening breathing. There are lots of voices and sounds filling the night outside, the origins of many at which John can't even begin to guess. Stars can be seen through the curtainless window.

"Can you hear that?" Sherlock whispers a moment later, and John focuses, trying to work out to what he's referring. Soon, he makes out a sound coming through a narrow, screened window that sounds like a bird hooting.

"That sounds just the eagle owls which nest in northern Europe," Sherlock whispers. "They've been extinct from the UK for over a century. I think I heard a nightjar before; Malawi has six varieties. They sound a bit like cicadas but have a lower pitch."

John smiles. _Of course, he would have memorised every animal, insect, and disease which live here as part of his research._

John realises that, despite how tired they are and how unfamiliar their surroundings are to Sherlock, he has already homed in on something that has piqued his intellect, his memory and his interest.

 _This could work,_ John thinks and yawns. _Maybe this can work._

Further evidence of this arrives moments later, when Sherlock's fingers underneath his palm give a tiny twitch, and he begins to snore in John's arms.

 

-o-0-o-0-o-0-o-0-o-0-o-

 

The next morning, they see the hospital for the first time. John observes Sherlock, trying to gauge how shocked he is. As it turns out, he has done his research and even the flies buzzing in the OR only cause the slightest crinkle of his nose.

 _He's fine, or he is very good at hiding that he isn't_. John can't decide which one is more likely.

One thing that does openly surprise John is when someone begins yelling in a side building in the local dialect of Chichewa, the national language. A man sprints out, and even though John doesn't understand what the group of nurses pouring out of the door after him are screaming about, everything about the spectacle seems to point to one thing: this is a thief about to escape.

When the man is about to run past, John steps in and tackles him. After a brief scuffle which is sure to leave his bad shoulder achy for a few days, the man is apprehended by a local policeman a small boy leads to the scene.

One of the nurses who have poured out to the yard, with passable command of English, explains that the man has been stealing medications from the hospital pharmacy. Said medications are now dug out of his pockets by the policeman and dumped on John's lap.

He looks up at Jens-Erik while trying to keep the packages from falling to the dusty ground. "You'd better fetch the pharmacist to sort these out."

Åse bursts out laughing and points her thumb at the thief. "That _is_ the pharmacist. He claims he hasn't been paid for three months, which is probably true since the pay comes from the government. So, he's selling the wares. We just haven't been able to catch him in the act yet."

John shakes his head and deposits the load of packages into the waiting arms of one of the nurses. It is only then he had realised that Sherlock is nowhere to be seen. John is certain that he'd been with them less than twenty minutes ago. A sudden worry hits: what if Sherlock had been so shocked at the conditions at the hospital that he had promptly returned to the Hauglands' residence to pack his things and get the hell out?

Thankfully, that turns out not to be the case. Once they manage to locate Sherlock with the help of a group of children who have been curiously following them around all day, John's fears turn out to be completely unfounded. His husband is standing on top of a ladder, nails held between his teeth as he is hammering back in a broken corner of a mosquito net in the small operating room.

"Ah, John. Excellent," Sherlock comments, then climbs down after banging in the last missing nail. He points to his companion, a local thirty-something man wearing a white shirt. "This is Joseph. According to the more linguistically gifted among the staff, they all swear he is the best operating room nurse this place has. I trust you to give him an education on my habits; I'm sure you've secretly done that at King's countless times. While I won't be able to pick my team for most surgeries, I'm going to need someone to make sure things run smoothly when I'm on duty. A right-hand man, if you will since you will be busy magicking passable anaesthesia out of thin air."

John shakes Joseph's hand, wondering if the poor chap has any idea what he's in for.  
  


  
-o-0-o-0-o-0-o-0-o-0-o-  
  


Another night, another new bed. At least it'll be theirs.

Just as Jens-Erik had predicted, their housekeeper Louisa doesn't bat an eyelid at them when they arrive. She simply chatters away in the local dialect, fussing with their bags and then dragging her new employers to a dining table laden with treats. Åse says that she understands quite a lot of English but prefers not to speak it unless absolutely necessary. John finds her demeanour disarming, and even Sherlock seems amused at her no-nonsense way of doing things precisely as she thinks they ought to be done, never mind a couple of Englishmen trying to meddle.

After serving dinner and seeing the Norwegians off, Louisa deposits John and Sherlock's largest bags on either side of a double bed in the master bedroom. That confirms Jens-Erik's assessment of how she would deal with the notion of a gay couple. She leaves for the night after doing the washing and placing a pitcher of bottled water on the window sill in the bedroom.

"She's…" John tries to find a word as they stand on the front porch, watching her walking down the road.

"Nice," Sherlock decides. "She just goes about her business. I feared having a housekeeper would feel intrusive, but since she was here before us…"

"I know what you mean. She's part of the place."

They settle in for the night and the day's excitement lulls John quickly to sleep. But, he is roused sometime before two in the morning by the mattress dipping and the floorboards creaking.

"Sherlock?" he mutters some moments later before even prying his eyelids open. If this was just a trip to the loo down the hall, his partner should have been back already.

There's no answer, so John flops onto his back and opens his eyes. Louisa has left a lit lantern hanging from the rafters on the porch, and in the dim light coming in through the window, John sees Sherlock standing in front of it with his back to the bed. His palms are pressed against his thighs, his fingers drumming and tapping frantically against his bare skin.

John climbs out of bed, his drowsy head expecting the need to curl his toes on the cold floor as he does in London, but the boards are warm.

Thanks to the creaky floor, Sherlock must hear him coming, and he might even see movement out of the corner of his eye, but he still flinches when John perches a palm on his shoulder. John squeezes it, then slides his hand down to enclose around his husband's fidgeting fingers. He can feel the tension in the muscles, the nervousness making Sherlock basically vibrate as he stands there, watching the unmoving darkness outside.

"Can't sleep. I need a cig."

"We don't have any. I think there's some whisky, though." John certainly could use two fingers of it.

"Alcohol is pointless."

John's lip curls up. _So is nicotine_. "What's got you up? Bed not good?"

"The bed is… acceptable. The pillows are lumpy, though."

"I'm sure Louisa knows where we could get better ones. Maybe Ikea delivers," John jokes.

His remark is met with silence instead of amusement.

Finally, Sherlock exhales, and his shoulders hunch forward a little. "John, the hospital is… I don't know."

"Not what we're used to? Bare-bones? Unhygienic by Western standards? Outdated? Overcrowded?"

 _We knew all this_ , John thinks. Still, it's quite a different thing really _seeing_ it, facing reality now that they're here. "It's okay to be put off. And it's okay to say it."

"It's horrible, John," Sherlock says quietly. "I knew what it would be like, we'd seen the photos, but it's different actually to be there."

"Still, it's the best the locals have, and we're here to make it better. I'm not sure they've ever had a brain surgeon before."

"A brain surgeon who certainly won't be doing any brain surgery in these conditions. Except for maybe subdural haematoma evacuations."

"It's not just our respective specialities which will be useful; it's everything we've ever learned in med school and in other training rotations. We get to make use of all of it, here, and that's what just might be the fun part."

"You sound like some preachy expert, but judging by how Western and fancy the Bastion hospital was compared to this, you haven't worked in very primitive circumstances, either."

"I went to Mozambique as a medical student for a one-month exchange one summer to help out in a charity-run vaccination project."

"Why didn't I know that?"

"You don't like talking about med school, so why would I have brought it up?"

"It's intolerable that I didn't know. I assumed that Afghanistan was the extent of your expertise." Sherlock sounds genuinely miffed, now.

"Why does that matter? It was just a student thing; I haven't been to Malawi before, and I haven't helped run a hospital or done anaesthesia in these kinds of circumstances. Every country's different."

"But, yet again, you will be the one who knows how to… function, how to behave. I thought we were on even ground, coming here." Sherlock crosses his arms. His tone is accusatory, as though John has kept something earth-shattering from him.

"I'm sorry I didn't tell you; I didn't think it was relevant. As I said, I haven't been to Malawi before, and Afghanistan's the only place I've worked in as an anaesthetist."

Sherlock's anger doesn't seem to dilute.

"Let me guess," John tries, "You're thinking that this might have been a mistake, that nobody could prepare for this, and you're asking yourself why we came here, and how will we manage, and that you're embarrassed to be having second thoughts at this point."

Sherlock gapes. "How could you possibly know all that?"

"Because all of that's in my head, too."

"Yet you look perfectly comfortable." Sherlock huffs in frustration. "As I said, you have more acclimatisation experience. So, yet again, I have to be the underdog."

"That's not why," John says pointedly. "I'm not as nervous as you, because I've got something to rely on."

"What?" Sherlock looks sceptically perplexed.

"You. I've got you."

An eye roll. "I can't possibly be––"

"It's sad that, even after all this time, you seem to think that you're the only one getting anything out of this relationship. I have you, we're in this together, and even if you don't have any more answers than I do on how to do this, I find it reassuring that you're here with me. Don't you feel the same?"

"Of course I do! I couldn't do anything without you!" Sherlock insists.

"That's not really true. You got through over thirty years of your life without me. You built a medical career without me."

"A career that was falling apart around the time we met because of who I am."

"Doctors get sued all the time. It wasn't because you're you that it happened."

"Yes, it did. I couldn't communicate, I couldn't throw around pointless platitudes, couldn't even convince a colleague that I hadn't been deliberately careless."

"But you've learned. So much, over the years."

"I hate that I have to learn things which come easily to others."

"Everyone learns. I sometimes have to put my foot in my mouth, too. And, you're brilliant, which I'm not. You're brilliant with a side of complicated."

Sherlock bites his lip and John can see the cogs turning.

"I like that expression," Sherlock finally says.

"Knew you would." John kisses him on the cheek. "This is an adjustment period. I hated Bastion at first. Then, I learned to love to hate it."

"That's ridiculous. I just…"

John hums inquisitively, trying to encourage his husband not to censor himself.

"I just… worry that it'll be the same as it is in London. That, once we are no longer awarded a long newcomer leash, they will all…" Sherlock trails out.

"They will all what?"

"Dislike me," Sherlock forces out from between clenched teeth.

"They don't all dislike you at King's. You've won over a lot of people. I'd even call some of them your friends. Marie, Alice, Greg––"

"That poncy anaesthetist from the cardiothoracic unit certainly isn't fond of me, and Anderson is certainly not my friend."

"Yeah, because he's your _enemy_. Shouldn't every great and memorably surgeon have some?"

Sherlock blinks slowly in begrudging confirmation of having accepted the premise.

John reaches a hand around his neck and presses his forehead onto his shoulder. It's a bit awkward given their height difference, but Sherlock complies.

"Let's go to bed," John suggests. "No use in fretting in the middle of the night."

"There'll need to be sex, then," Sherlock says, extricating from John's hold around his head and walking to his side of the bed.

"Like I just said, it's the middle of the bloody night," John groans. _Trust Sherlock to do a complete 360 degrees from upset to horny_. "Can't you manage without until the morning?"

"I don't have a pressing need for it, but it's the only chemical means of anxiety alleviation currently available. I can't sleep until I have… something," Sherlock mutters, sliding under the sheets.

John drops his head on a pillow. "Alright, alright, you impossible madman."  
  
  
  
  



	6. A Timeout

**Notes for the Chapter:**

> In this chapter an upsetting medical case involving a newborn child is remembered in past tense, not in very graphic detail. A term denoting a practice of child sexual abuse in Afghanistan is used but not explained in the chapter (I have explained it in the ending notes).

 

 __  
  
Adjustment period.

Two words Sherlock keeps repeating in his head like a mantra when he's getting overwhelmed. Lizard dropping onto his shoulder in the rainwater shower in their back garden? _Adjustment period_. Patient dying because they have no intensive care unit? _Adjustment period_. Getting stuck in the mud with the car and arriving at the hospital with his head full of caked dirt after pushing it? _Adjustment period._

But, does such a period end? They've been here for a month.

"Stapler," Sherlock commands without thinking. His extended hand, covered by a sterile glove, receives nothing because he should have remembered that staplers are nothing but a surgeon's wet dream in these parts. Here, he's lucky to have enough thread for regular sutures.

Today, luck isn't on his side. It never seems to be when it comes to the rickety equipment at St Mary's.

"It last packet," today's scrub nurse tells him with her heavily accented English, pointing to the six-inch bit of thread still attached to the needle Sherlock had placed back on the Mayo table.

"How am I supposed to close the peritoneum without––"

"We have five-zero Vicryl," the scrub nurse tells him in a hopeful tone.

5-0 Vicryl is an absorbable polyglactin thread that will barely hold non-tense surface layers together. The peritoneum requires something much, much sturdier.

"What about the skin? Shall I just put a bit of duct tape on?" Sherlock asks venomously.

"We have five-zero Vicryl," the nurse, unfazed by his tone, repeats sunnily.

Sherlock huffs and accepts the damned thing because beggars can't be choosers in these parts. The patient's abdomen has to be wrapped with something that will support the flimsy sutures; perhaps they can find an elastic binder or at least enough gauze or an old sheet that could be cut into ribbons...

The patient is a young woman who has fallen from a roof onto a pile of firewood with branches sticking out. One had perforated her stomach, and Sherlock has fixed that and managed to remove the irrevocably damaged part of her colon. He isn't very confident yet in his bowel seam skills, but it hasall gone rather well, giving her a chance of recovery—assuming she doesn't succumb to infection or seam failure and the ensuing fecal peritonitis. The ketamine anaesthesia is being monitored by a nurse; John had been forced to go back to the A&E room after anaesthesia induction to see to a car accident victim.  Thankfully, ketamine does not depress haemodynamics so the intubated woman is stable as long as the respirator keeps working. 

He closes the incisions in more layers than usual, using the loose subcutaneous tissue to support the skin stitches. If the patient doesn't strain her abdominal muscles too much, it might hold. The trouble is that many patients disappear from the hospital as soon as they can walk, assisted by their relatives back to their home villages. There isn't enough nursing staff, so it puts on a burden on the families looking after the sick. For this, they have to leave their crops and their animals behind, so they are understandably eager to transport the patient back home as soon as they can.

In London, it had been the bureaucracy and the lacking infrastructure in the NHS that had prevented Sherlock from doing his best for his patients. Here, he battles poverty, lack of even the most basic equipment, a shortage of trained staff, superstition, and the limits of his own endurance. There are so many patients, toomuch to do, and not enough healthcare professionals to do it. He's being pulled in a million directions the moment he steps inside the hospital in the morning, and the same applies to his husband who he barely even sees at work unless John is gassing for him. A doctor is a doctor, so they are both consulted in matters pertaining to any and all specialties, from epilepsy to hyponatraemia to heart failure to diarrhoeic children. Sherlock constantly and painfully meets the limitations of neurosurgical training compared to what an anaesthetist knows about homeostasis, pain relief, critical care and internal medicine. He has been reading up on anything and everything he comes across to keep up—and of course John is way over his head a lot of the time, too—but it still grates on his nerves and his confidence that his speciality just may be less useful here than John's.

Yesterday, a baby had been born in the village and brought to the hospital. Clearly, the boy was a preemie, and an X-ray and some basic examinations had revealed hypoplastic lungs and a tracheo-oesophageal fistula and an oesophagus that was but a cul-de-sac. All food ingested would just slip into the underdeveloped lungs instead of the stomach.

There was nothing they could do. Even a Western world hospital with a world-class neonatal ICU and neonatal surgeons would struggle with such a case. The only proper neonatal units in Malawi would require a flight to get to, and the baby wouldn't even survive the transport.

A nurse had translated as the mother clung to Sherlock's shirtsleeve, begging him to do something.

"I can't. I'm not the right sort of surgeon. I'm sorry," he had muttered. He can read up on fractures and adult surgical problems and operations for bigger children, but a premature baby was a whole different matter. Even John, standing off to the side of the bed the baby had been laid on, was shaking his head. Even if they were the last surgical team on Earth, it would be insanity to try anything.

"I'm sorry," Sherlock repeated, and extricated himself from the situation.

Is this how it's going to be for the next seven months: a constant stream of _I'm not and I can't_?

He knows he's the best these people havewhen it comes to surgery, but his training still feels woefully inadequate for the endless needs and the massive variety of problems this populace has. At least they take his medical opinion at face value but having to keep delivering bad news at a much more brutal a rate than at King's is getting to him. It must be getting to John, too—why wouldn't it be?

John is just so much better at softening the message. Here, it's even harder to gauge than it was at home what kind of behaviour the locals expect from a surgeon, from an anaesthetist, from a physician. They seem to forgive Sherlock for staying silent when he doesn't know what to say, for not lingering when the crushing words have been delivered.

They thank him—for what? Honesty? For the time he has given them? He had come here wanting to experience old-fashioned physician autonomy and appreciation, but now that appreciation for his mere presence leaves him deeply uneasy, because it doesn't banish the constant sense of inadequacy. It's hard for a doctor to say no when being asked for help, even if they know there is nothing they can do.

He has been working for seventeen hours straight. Every time he had been trying to allow himself a break to eat, nap in the deck chair placed on a balcony upstairs, or have a shower, someone had come yelling for help.

_I shouldn't ruminate about this so much. There's work to do._

Having done the last suture, Sherlock steps back and pulls off his gloves. He feels momentarily faint in the heat of the OR—the air conditioning has been acting up again, presumably because someone has stolen the fuel. The local criminal population is not unusually large; poverty and opportunity simply often create a temptation too intense to resist.

When he walks out of the OR into a corridor, some beetle scuttles across his path. Yellow dust swirls intherays of late afternoon sunlight streaming in from the windowsand,since the corridor is not air-conditioned,it feels like a sauna.

Sherlock leans down on his haunches at the end of the corridor where there's some shade, his back against the warm brick wall. He's hungry, exhausted, out of his depth, he needs a shave, there's sweat trickling down into his back into the cleft of his arse which tickles like mad, he hasn't had a shower in three days because there's a drought and the rainwater tank in their back yard leaks anyway, it's too damned hot evento think ofsex, he barely sees John because John effectively runs all the wards now because none of the local so-called medical officers without much actual medical training know what they're doing, and they've not even halfway through of this ordeal.

Right now, it's so hard to banish the question of whether coming here the stupidest idea he has _ever_ had. John seems to have it easier: unlike Sherlock, he doesn't get prickly heat under his sterile gloves, doesn't suffer from insomnia because of the stupid frogs making noise by the water tank (the racket can't be muted by earplugs because in this heat they would only infect Sherlock's ear canal _again_ ), and his noise-cancelling headphones had broken down only three days into their stay because of the humidity.

John is fine, and Sherlock is struggling. John did try to tell him this would happen, and he wouldn't listen. He should have listened, because his husband has worked aboard before.

 _Hubris. Arrogance. Naiveté._ Sherlock is certain that these words would quickly come into play if his colleagues at King's saw him right now. The coming months stretch before him like a prison sentence as he leans his forehead on his knees and drops his bottom on the floor. He shouldn't sit on the ground with his scrubs, but then again, the locals don't seem all that mindful about hygiene so why should he bother?

Why isn't he at OR number four of the neurosurgical floor at King's, dressed in nicely fitting, clean, intact scrubs, accompanied by people who understand his language and who can give him exactly what he needs to operate up to the standards of the 21st century? What the hell is he doing here?

He has tried to keep such doubt at bay, telling himself in the evenings (after he crawls to bed next to John to roll around in sweaty sheets as a poor excuse for actual slumber) that he's simply too tired to think straight, but today, the pressure is mounting and he fears that if the constant barrage of a veritable catalogue of physical discomfort doesn't ease off, he's going to suffer a meltdown.

He cards his hands through his hair, the pleasant sensation of his follicles being tugged helping himto calm down. He flinches when a third hand joins in, and his eyes snap up to identify the intruder.

"Hey," John says, and tucks a sweaty, messy, disgusting curl behind Sherlock's ear.

Sherlock doesn't reply, just lets his hands drop and his forehead descend on his knees again.

"You alright?" John asks, concern thick like molasses in his tone.

John knows him so well; it's a relief not having to say no out loud. John will deduce it.

He doesn't want to talk. He wants to go home. Home, to their nice, soft bed and their stocked fridge and his violin and John's stupid crime novels and their espresso machine and their car and even that stupid imbecile Anderson would be better than dying children he's expected to save and having to use bloody five-oh Vicryl on peritoneal sutures.

"You look done in. Come on," John prompts, extending an arm. He's wearing a white T-shirt stained with sweat and mud-green shorts with lots of pockets. Sherlock has always liked him in a T-shirt.

His stomach gives a lurch; whenever he doesn't eat for more than four hours, the malaria pills keep upsetting his digestive tract.

"Come on, trooper," John says with a smile.

Finally, Sherlock takes hold of his wrist and gets gently pulled to his feet.

"We haven't taken a breather for days. Soldiers get furlough; here, we've got to look after ourselves. Let's go," John says and begins walking towards the main entrance.

"Where?" Sherlock blinks, bewildered and tired. He grimaces when he adjusts his scrub shirt and gets a whiff of the sweat permeated in the fabric. He's never felt this grotty in his life. He hurries after John, still feeling a bit faint. He probably hasn't drunk enough water.

Once they reach the entrance, Sherlock sees a chicken running across the hospital courtyard, chased by some children just as he catches up with his partner. "I can't go anywhere—I was supposed to go back to the surgical ward––"

John is purposefully leading Sherlock to the car owned by the hospital which they are allowed to use for their commutes. His stern glance makes Sherlock's further protestations wither away.

"There's always going to be the next patient, and the next—there's more to do here than any doctor could ever manage without running themselves to the ground. I know what it's like, at first – I remember my first deployment. They had to _force_ us to take time out, because we knew that the stream of patients would never stop. We're useless if we don't look after ourselves."

"Is this when you tell me that we can't save everyone?" Sherlock asks, and slips onto the shotgun seat as John circles around to the driver’s side. "Where are we going? We can't just leave in the middle of the day."

"I've been to the wards, and there isn't anyone needing an op right now. There are no office hours and no work contract with the hospital. We need a time out— _you_ need a time out, right now. Even Joseph was saying you look like a ghost. No, you can't save everyone, but it doesn't mean that the ones you do get to save don't matter. They _all_ matter, every little bit. When we can't save someone at King's we treat it like a failure—as though Western medicine can perform bloody miracles. Here, everything we do is better than what these people would have without us."

Sherlock remembers, once again, that he hasn't changed into his own clothes. "Where are we doing? I'm still in scrubs." He's repeating things and his brain feels like it's full of cotton wool.

John grabs a large bottle of water from the dashboard and drops it into his lap, followed by a chocolate bar dug out of the glove compartment. It's melted into the paperand a bit squished, but Sherlock scarfs it down in moments, chasing it down with half the water.

"Your scrubs aren't going to matter." John shoves the old jeep into gear.

 

-o-0-o-0-o-0-o-0-o-0-o-  
  


  
Twenty-five minutes later, John pulls up next to some tall reeds at the end of a narrow dirt road. He turns off the engine and pockets the keys, then leads Sherlock through the reeds.

Sherlock is glad to be wearing his OR trainers in the thick undergrowth, though hiking boots would be even better. His socks are going to be disgusting from all the sweat; he has tried going without them like the locals, but he hates the feeling of just the trainers on, and sandals he won't even discuss. The sensation of sand between his toes and between his soles and a sandal bottom is just… He shudders at the thought. John, who isn't bothered by such things, is wearing a reasonably stylish, dark brown leather pair.

John leads the way through a copse, consulting a hand-drawn map he has now dug out of his shorts pocket. Suddenly, the undergrowth disappears and they're on the banks of a river. Two local women give them a smile as they are doing laundry in a briskly flowing section. About a hundred metres further is a small waterfall landing into a clear pool reflecting dark green foliage and specks of blue sky visible through the thick canopy.

John pulls his linen shirt over his head and hangs it on a branch. Sherlock is certain it'll be full of insects soon. He hesitates by the treeline as John strides towards the pool.

"Come on," John prompts. "It's a local secret spot, and much better than a shower. Two nurses from the maternity ward drew me a map."

The water does look enticing, but... "What about bilharzia?"

Schistosomiasis, also known as snail fever and bilharzia, is caused by a flatworm spread by infected freshwater snails. It's widespread in freshwater basins in Africa.

John turns to look at him while continuing to unbutton his shorts. He doesn't seem at all perturbed by the fact that two local women are about to see his white briefs. "I asked Åse and she says that any water that flows hard enough is going to be safe, and the water in the natural pool here constantly changes from a river that flows into it. It's fine, Sherlock," John says pointedly, "The locals swim here all the time."

Sherlock watches his husband discard his shorts and his shoes and then waste no time in wading in. John gives a delighted, wordless hoot and the women giggle.

Sherlock pulls his scrub top over his head. He doesn't have any underwear on, so he'll have to do this in his scrub trousers. They'll dry quickly in the hot air afterwards.

After finding a suitable rock for his shoes, he carefully lowers himself into the water, worried what the bottom will feel like on his soles. As a boy, he'd been taken with Mycroft to visit some French relatives by their summerhouse on a lake, and the bottom of the lake had been disgustingly muddy. He still has nightmares of how it had felt like being squeezed between his toes.

Thankfully, the bottom here turns out to be sandy. _Acceptable_. Sherlock tries not to worry about snakes and other things that may visit the spot to cool off in the African heat.

The women fill their baskets and leave while Sherlock stands in the middle of the neck-deep pool, relishing the feeling of moving his hands beneath the cool, crystal clear water. Once they're alone, he kneels down to get his hair wet—he'd need shampoo to give it a proper scrubbing, but this will have to do, until it rains and the water tank in their house fills up.

"This doesn't change anything," he tells John grimly. "We have to go back and get on with work."

"Yeah, but this is sort of how we do things in London." John wades closer. "We go to work, then have some time off. Here, it's just more intense. We just need to get into a better routine."

It doesn't require much soul-searching for Sherlock to admit to himself that John is right. Not knowing when there might be time for a breather has been breaking his spirit the most. He's trying to do too much, because there's too much to do. He should trust John's judgement—after all, he's worked abroad before.

John shifts to stand behind him, snaking his arms around Sherlock's waist. "You know what I hated the most in Afghanistan? My top three?" He straightens his back, or perhaps he'd just stood on a submerged stone since his rises from the water and lays his chin on Sherlock's shoulder. "Deathstalker scorpions. Big ruddy bastards. The first time I saw one, we were camping outside, and I couldn't sleep for two nights, worried I'd be staring at one of them when I woke up. Number two: seeing the kids living in that chaos. Injured by gunshot, grenades, child brides, young boys being sold to prostitution. Ever heard of _Bacha Bazi_? They claim that it's gone extinct, but even US forces have been accused of turning a blind eye to it. Number three: ball chafe in the heat, until I was told baby powder works like a dream. Wasn't something they covered in basic training."

Sherlock chuckles and shifts around in his husband's arms. "I hate the shower situation. I hate having to worry about getting sick if I eat something someone at the hospital offers me. I hate that I can't really do neurosurgery here."

"There you go. You're allowed to hate things. You're allowed to think a lot of this sucks," John tells him and leans in for a kiss, carding his fingers into Sherlock's matted, wet hair.

The press of their lips together is gentle, at first, not yet crossing from loving to passionate. This isn't the time or the place for this to develop further even if they are alone in the woods. Instead, it's a reassurance, a reminder to slow down, to refocus their energies by spending time together when they feel drained.

"Your hair's disgusting, Doctor Holmes," John teases, combing a knot open in Sherlock's fringe.

"Likewise, Doctor Watson with the ball chafe," Sherlock counters with a sly grin.

"I did pack the baby powder. Might give you a lesson in its application."

"I've solved it by forgoing pants."

John gives him a wink and slithers his hand down the front of Sherlock's scrub trousers under the water, gently caressing him before returning the hand to his partner's waist.

"Only you could get _interested_ in this bloody heat," Sherlock complains and pulls John into his arms so that their chests are pressed tight against each other. His is much paler; his lighter complexion means that he burns easier than John does, so he doesn't share his partner's habit of discarding his shirt while sitting in the garden of their house. John's folder of army photos is well stocked with shots of him without a T-shirt on. He has a bit more chest hair than Sherlock does, but not a large amount. Everything about his is just the way Sherlock would prefer.

They stand still for some time, enjoying the embrace. When their arms eventually loosen and drop, Sherlock closes his eyes, enjoying the sensation of the water lapping their skin and the slight spray from the waterfall pricking his face if he turns partly towards it.

Maybe he can do this. Maybe, if he gets to spend this sort of free time with John, he could do this. Right this moment, he could even trick himself that he's holiday, and to be able to experience such a shift in less than thirty minutes after feeling miserable is nothing short of amazing. He doesn't like the idea of returning to the hospital, but the notion doesn't feel entirely soul-crushing anymore.

"This isn't easy," John whispers to him. "But you're doing so, so well. Not everyone could do this, and the worst is over already."

Sherlock's nose scrunches up with slight dismay. "I didn't come here just to _suffer_ _through_ something."

"Are you currently suffering much?" John asks, wades a few steps away and spreads his arms. "After I give you a lift back to the hospital I'm going to the house to see what I can do about the shower, drought or no drought."

"If you fix it, I might be inclined to give you a tour of what I am or am not wearing underneath these scrubs."

John laughs and splashes him with a bit of water. It's juvenile and unbecoming of a Consultant anaesthetist, but that's not what John is right now. Thinking that a Consulting Surgeon is what he has been twenty-four seven has drained Sherlock, but now John has shown him that there's an alternative to feeling inadequate and working himself to the ground.

They just have to remember who they really are underneath their scrubs and all the crushing responsibility.

   
  


**Notes for the Chapter:**

> Bacha bazi, 'boy play', is [a terrible Afghan tradition of prostituting young boys to older men](https://www.hindustantimes.com/world-news/bacha-bazi-the-stolen-childhood-of-boys-turned-into-dancers-sex-slaves-in-afghanistan/story-5FrGrKI2PzrSRynHSfzh2N.html). There have been accusations that coalition forces have been [aware of the problem but wilfully ignoring it](https://nationalinterest.org/feature/americas-enduring-bacha-bazi-problem-afghanistan-23557). Kitted out as though they were women, these [boys are effectively sold after they perform at dance parties](https://www.thejournal.ie/sex-slave-afghanistan-bacha-bazi-children-3464413-Jul2017/).


	7. The Consulting Detective and His Anaesthetist

>   
> _Don't think there are no crocodiles just because the water is calm._  
>  —Malawian proverb  
>   
> 

  
Commotion in the hospital's front yard attracts John to the main entrance to see what's going on.

A porter runs past him deeper into the building, yelling for ' _Doctor Holmes_ '.

 _Must be a new patient urgently needing help_ , John reasons, and hastens his steps.

A blanket lies on the dusty ground, a man on top of it, eyes closed and unmoving. Seven people have gathered around him; they are wringing their hands, wailing, and touching the patient reverently.

In no time at all, Sherlock sprints to the yard and soon, he and John are kneeling by the man on the blanket.

The patient doesn't respond to being spoken to, his shoulder being shaken, or even when John presses a fingernail to where his supraorbital nerve is located above the eye. There's no breathing, so John searches for a carotid pulse. Strictly speaking, it's not even recommended by the European Resuscitation Council in order to start CPR, but something tells John the man may already have been dead for some time, so perhaps spending a few seconds more examining his is permissible. "Nothing."

Sherlock seems to have had the same hunch since he's poking a finger into the man's stomach; his shirt buttons are open, and the fabric bunched up on his sides.

"Lividity. There's nothing we can do anymore," Sherlock announces to the crowd. Their puzzled and frantic expressions signal that they haven't understood a word.

John tries to extend the man's elbow and to shift his chin; the latter is stiff, but the elbow joint still moves.

Joseph emerges from a side door, his face a question mark.

Sherlock rises to his feet, straightens his back. "This man has been dead for at least two hours but less than six, although the heat may have sped up the process. Joseph? Care to translate a bit for these people?"

One of the hospital guards—the only one with a passable command of English—explains that the family had discovered the man inside his house and carried him six miles to the hospital in the blanket.

John circles around the body and is pointing at the man's side. "I guess that's the cause of death," he says. There's a four-centimetre wide, round hole there.

Sherlock sits down on his haunches. "Not so fast." He lifts the bunched-up shirt and compares the blood on it to the wound. "If this killed him, it should have bled more." He looks up at the guard, eyes sharp and expression focused. "Did they change his clothes? Is this what he was wearing when he was discovered and was there blood on the floor?"

The guard addresses the crowd, and a woman with a baby inside a cloth hung around her neck steps forward. Tears are running down her cheeks. She explains something, gesturing wildly with her hands, but as much as John tries to make sense of what she's trying to convey, he's left confused.

"That's a no, then?" Sherlock asks Joseph. He has stood up to his full height. John is envious how fast he seems to be picking up on the local dialect of Chichewa.

"No dogs in house when find him. No animals. No change shirt," Joseph confirms.

Sherlock is squinting in the bright afternoon sunlight as he fixes his gaze on the woman. His face is a mask of determination, unwavering focus and curiosity. "What do you mean, 'no animals'? What relevance does that have?"

Joseph steps forward. "They would have licked up the blood," he replies quietly, glancing at the crowd obviously hoping that they won't understand his words. "They just put him on the blanket, didn't clean him or change his clothes."

"What does this man do for a living?"

"Hunter," the guard says.

The woman steps closer to Joseph and quietly explains something, stealing nervous glances at the crowd.

"He been in trouble with police," Joseph tells the two doctors.

John folds a bit of the blanket over the man's face to cover him respectfully. "What sort of trouble?"

Joseph addresses the grieving woman again, and John wonders if this is the wife. This time, she seems even more reluctant to answer.

"Tell her we're bound by confidentiality," Sherlock prompts in a pressing tone. John conceals a smile; Sherlock loves a good mystery and has now got the look of a bloodhound on a trail.

Joseph frowns. "There are many people here now, they not bound by it."

Sherlock pivots on his heel to face the guard again. "Can you get the crowd to back up a little?"

The guard ushers the extended family to the shade by the main entrance.

"Where does he hunt?" John asks the woman.

The baby fusses a bit, so the woman rocks a little on her heels, which calm the child down. She says a word which sounds like a place, but John can't be sure.

Sherlock's eyes light up. " _Liwonde_!" he repeats excitedly. "That's the national park where the black rhino was re-introduced after it nearly went extinct in the whole country."

He flounces back to the body, digs out a pen from his pocket and sticks it into the wound on the man's side. "Wide on the outside, tapering down to a narrow channel. No household tool would match this. Too round to be a knife wound."

"National park? Are the locals allowed to hunt there?" John asks.

Sherlock flaps a hand behind his back towards John, still focused on poking around the wound. " _Precisely_ the point, John. This man was most likely a poacher," he announces, perhaps a bit louder than necessary.

An older woman in the crowd seems to stir at his mention of the word, and steps forward, unleashing a frantic word salad at Joseph. There's a word she keeps repeating.

John tries repeating it, too, but speaking quickly in Chichewa is not his strong suit. "What's that mean?"

"Rhino," Joseph replies. "She's asking if it's the spirit of the animal come to…what's the word…when you pay back something bad?"

"Avenge?" John suggests.

"How wide is a rhinoceros horn?" Sherlock cuts in.

Joseph gives him a measurement with his fingers.

"That's consistent with the wound, but it didn't kill him. It could have…Velocity combined with striking distance…Why mention a specific animal…I'd have to make a more thorough examination to discern what internal organs have been damaged, but there isn't enough blood to kill him, assuming he hasn't been lying in his house getting sepsis for some time. When did anyone last see him alive?"

"This morning," the guard replies after crowdsourcing the people in the shade. "Less than seven hours ago."

Sherlock clasps his hands behind his back and begins pacing by the body. "Consistent with the lividity." He spins back to the body, drops to his knees beside it and properly reveals the man's entire torso by pulling the halves of his shirt to the side. "Look at this, John." He's pointing on a darker-coloured area of skin underneath the ribcage on the right. He then lifts up the man's hands, using his pen to scrape under the nails. He digs out a tissue from his pocket to catch what flakes out.

The crowd starts getting restless.

"Sherlock?" John asks. "What are you doing?"

Sherlock leans closer to the man's face, shifting his short-sleeved dark green shirt again to have a look at droplets of blood on his collar. Suddenly, he gasps and jerks backwards, landing arse-first on the dusty ground. A black beetle has just crawled out of the man's mouth, which must have startled him.

The edge of John's mouth twitches upwards a little, but he manages to keep his expression respectfully sombre.

Sherlock also regains composure quickly, climbs to his feet, and pats dust off his hands to his shorts before addressing the guard again: "You should contact the Eastern Region Police Headquarters in Zomba and the local medical examiner. I think this man is the victim of a homicide."

  
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Seven hours later, two officers drop by at the hospital. They conduct short interviews with Joseph, the guard and the two doctors, who have lingered behind after finishing the day's duties to help with the examination. John has been on pins and needles to start driving home; the sky has darkened with thunderclouds and driving in the dark can be risky even in good weather due to all the animals wandering onto the potholed roads.

When the officers start preparing to leave, Sherlock blocks their way out in the main corridor. "What about the body?"

"The family can have the body," the senior officer replies.

"Shouldn't the medical examiner claim it first, and do a post-mortem?"

The officers glance at each other. John has learned to recognise this look in the locals; it's the one they exchange when foreigners are suggesting something that clearly indicates they have no idea how things work around here.

"There is no medical examiner here."

"How can you find out what happened if there's no autopsy?" Sherlock demands, arms akimbo.

"We interview family, people who were there. Maybe see his house. It looks like an accident; he hunted in Liwonde, maybe rhino get to him."

"That's the _opposite_ of what I have been telling you all evening!" Sherlock exclaims. "If he got attacked by an animal, how did he get home from Liwonde? If that wound killed him in hours, it must have bled, and he couldn't have driven or walked in that stage. Does he own a car? If not, who drove him back? Was the wound created pre- or post-mortem? Why was there no blood in his house, if he died there? Did he die in the car and someone moved him to conceal their involvement in poaching? Why is there human skin tissue under the victim's fingernails?"

John had assumed Sherlock was just trying pass the time by putting the flakes he's fished out from under the man's nails under a microscope.

"Family can have body. We may look at his house tomorrow," the officer replies disinterestedly. "Family gone home, now, they will collect him tomorrow for funeral."

"He was brought to us, so _technically_ , he's still my patient. I will examine him," Sherlock announces, and it doesn't sound like he's asking for permission, just announcing his intention. "Will you receive my report, and act on it?"

The younger officer shrugs. "If you can prove murder, then yes."

 

-o-0-o-0-o-0-o-0-o-

  
" _JOSEPH!_ " Sherlock bellows when the lights flicker yet again before going out entirely.

John has already lit two gas lanterns and brought a flashlight into the operating room since power-outs have regularly been happening during the past two hours. The thunderstorm has arrived, and rain is pelting the roof of the hospital annexe where the OR is located, sounding like muted gunfire as the droplets hit the metal roof.

Joseph jogs back into the OR, arms laden with things. "Generator not working. Rats chew through cabling again, new ones we get tomorrow."

"I told you to get four sets of spares," John sighs.

"We had four pairs, now no pairs."

Stealing from the hospital continues to be a big issue. Without locked cabinets, lots of things from cables to medications prove too enticing to locals struggling with poverty.

Joseph's loot contains three more lanterns and a box of large candles which he starts arranging around the OR. The flickering flames and the howling wind create quite the atmosphere for what Sherlock is about to do.

"I feel like Victor bloody Frankenstein," he comments, placing a tray of orthopaedic instruments on a Mayo table by the body. Sherlock is wearing a plastic apron on top of his civilian clothing instead of scrubs since no sterility is needed for an autopsy.

"At least you're not trying to bring him back to life," John comments and claims a chair beside the operating table. He has promised to be Sherlock's note-keeper.

Joseph bids them a good night; he had clearly been reluctant to even assist in the preparations. Even though the man is quite science-minded, local superstitions still have a hold on him. Joseph had said that it was best that they didn't explain much to the family about what they were doing, simply said that they needed to take samples for the police. John wonders if they'll believe it once they see the sewed-up autopsy wounds on the torso. He knows local customs require the family to handle a body extensively—to wash it, to clothe it, among other things. Such practices are a significant factor in diseases such as Ebola spreading in funerals. Close to eighty per cent of the people in Malawi are Christians, but old animistic beliefs still merge with Christian and Muslim doctrine. In the Zomba area, Muslims are the majority, and their customs dictate that a funeral should be held as soon as possible, but if foul play is suspected an investigation is deemed important.

Joseph has explained to them that, when someone dies, the whole village often attends the burial. At his invitation, John and Sherlock had gone with him to the funeral of one of his relatives three weeks ago. It had been a surprisingly joyous celebration, and Joseph had explained that burials are big social events where people drink beer, eat, and meet others.

Sherlock dons two pairs of gloves, picks up a scalpel and makes a long incision from the man's pubic bone to his suprasternal notch. Finding the right tools to complement the ortho tray had not been easy; one of the things Sherlock had chosen are the hospital gardener's branch cutters which he plans to use for getting the sternum open. "Not bad," is Sherlock's assessment of their functionality for the job after prying chest cavity open.

Before having a look inside the thoracic and abdominal cavities, Sherlock picks up a measure and a probe to have a look at the wound on the man's side. He uses a magnifying glass he has magicked out of somewhere to cut a few slices of flesh carefully from the edge of the wound with a scalpel. Those he drops onto glass slides; they'll need to be sliced with the microtome in the hospital laboratory before they can be examined under a microscope.

"There's no distinct haemorrhagic pattern in the wound edges, and the lack of bleeding confirms that it was created post-mortem. I'll have a look at the mast cells on the edges of the wound; if they haven't de-granulated, that further confirms that the body could no longer react to such trauma by the time it was inflicted. As I suspected, someone tried to make it _look_ like this man was attacked by a wild animal. A crude attempt but, judging by the level of competence of the local police, the killer could have gotten away with it."

"Unlucky for them, then, that you were around. Consulting Neurosurgeon Holmes turns into Consulting Detective Holmes," John jokes.

Sherlock pushes away a sweaty lock of hair with his wrist to avoid touching his face with the now blood-stained gloves. "You have the same amount of training in basic medical forensics as me. You could have worked all this out, too."

John smiles. He probably could have, if only it had occurred to him to look closer, to question things, and to get curious about what had happened. The living are John's patients, not the dead. For Sherlock, however, every human body is a source of fascination. John is reminded of the joke videos on Youtube supposedly illustrating the mindset of a surgeon; if there's a fracture, they need to fix it, never mind if the patient is already dead. He'd shown them to Sherlock after having a lark watching them with his anaesthesia colleague at work. Sherlock hadn't understood at all what was so funny about them.

Satisfied with his examination of the stab wound, Sherlock begins inspecting the internal organs. The heart is intact and so are the lungs, but the diaphragm is what brings on the widest grin. "Diaphragmatic rupture! Often missed in the UK, too, even though it occurs in up to eight per cent of blunt-force abdominal trauma. Vehicular accidents are a common cause, and penetrating trauma often injures the diaphragm as well, but there were no signs of an impact visible in the upper abdomen. The left side is less protected by the liver, explaining why most significant injuries occur in left-side impacts," he rattles off almost gleefully, hands wrist-deep in the chest cavity.

The sight is a far cry from the subtlety of brain surgery, but Sherlock seems to be having fun regardless. Amused, John shakes his head slightly, pursing his lips as a grin threatens to break out.

"There are no costal fractures and, as far as I can tell, the lungs are fine, which would speak against any impact with a large object such as a car. No, this was localised damage—a limited area impact that happened to hit a sweet spot. Aha!" Sherlock announces and lifts up what looks like either a kidney or a spleen. It's swollen and tense even post-mortem. He places it on a metal tray and pierces the surface with a scalpel. It bursts open and blackish, clotted blood oozes out, turning the tray into a mess.

" _Oh!_ " he exclaims gleefully. "Massive sub-capsular bleeding into the spleen. It doesn't explain all the blood in the abdominal cavity, though." He shifts back to stand by the body again, leaning close to the open abdominal cavity.

John leans closer, too; he's eager to see what Sherlock might find next.

Sherlock blinks at the ceiling as he focused on rummaging around the corpse. "There _is_ a rib fracture, after all, and a piece of it has been lodged downwards. I nearly missed it because it was close to where I'd cracked through the thoracic cage." Now, he leans in closer again. "The renal vein has been cut by it. That's it—he bled to death internally. The stab wound doesn't extend beyond the muscle layer; it hasn't even properly pierced the peritoneum. Someone created it to stage this as an accident."

"Blunt force trauma, then. With what?"

Sherlock tips the small metal tray he'd been using as a cutting board above the body so that the bloody pieces of the spleen and the coagulated blood slide back into the abdominal cavity. "I can't tell at this point. I'm not well-versed enough in forensics to say whether a fist could have done this. In any case, he was hit by something in the left upper quadrant of his abdomen. He died, which was perhaps the assailant's intention. Inflicting the stab wound to stage this as a hunting accident could point to non-murderous intent. Either way, I don't think we're looking at a seasoned killer. If a rhinoceros horn was used to create the diversion, then whoever has it must be the culprit. Parts of black rhinos must have quite a high price in the black market, and the person wouldn't probably sell it right away since the connection to this man's death would be obvious. News travels fast through the gossip mill in these parts when there's something unusual going on. If the killer wants to sell it fast, they'd have to travel somewhere else to do it if they wanted to escape notice."

John helps him clean up the OR and wrap the body in plastic. The phone lines still work, and they call the police district headquarters in Zomba. Reluctantly, the officers agree to come back for a second interview with Sherlock and to add his autopsy notes to the case files. To Sherlock's great annoyance, they won't let him tag along to investigate the man's home.

  
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A week later, Joseph tells them that the victim's brother has been arrested for murder. He owns a car whereas the victim did not, and there had been an argument about splitting the earnings from a poaching trip. Suspicion had fallen on the brother after he had missed the funeral to travel to another province. There, he had planned to sell the black rhinoceros horn he had stolen after striking his brother with the stock of the man's hunting rifle. Joseph told them that the brother had feared the funeral, certain that the spirit of his dead brother would harm him if he attended; that's why he had wanted to be elsewhere at the time. He was caught by the police with the horn still in his car.

   
  



	8. It Never Rains but It Pours

**Notes for the Chapter:**

> I'm back! After a most excellent holiday in England staying with 7PercentSolution, I am ready to share with you a long, emotional and exciting chapter.
> 
> Trigger warning for potentially upsetting medical situations.

> _The lead cow gets whipped the most._  
>  —Malawian proverb

  
  
John had expected for the African way of hospital work to clash disastrously with Sherlock's pedantic approach, but that assumption is turning out to be wrong in all the ways that actually matter. Here, a fully trained neurosurgeon is a rarer treasure than a three-kilogram diamond, and patients and staff revere him no matter how he behaves. That respect seems to put him at ease in a way John has never seen at King's College.

Conditions at St Mary's are undeniably tough—there are shortages of nearly everything needed for surgery, and when things break down the wait for spare parts is often long. At least there are two things which are always available: disposable gloves, and HIV drugs, thanks to some huge government initiative the president likes to gloat about on TV.

It has greatly surprised John how enthusiastic and dedicated Sherlock has been in teaching some of the staff. After seeing him struggle with Alice—Sherlock's registrar in London—John would have assumed some of that apprehension would have lingered. Instead, Sherlock is a confident man conveying clearly and concisely what he expects and somehow, he has amassed admirable patience even towards the local staff. Maybe it's because here, he isn't being watched by the judgemental eyes of his colleagues. Here, he is respected just for who he is, and no one is questioning his judgement, skills, or abilities. Here, his social ineptitude is mostly concealed by the fact that he's a foreigner who can't be expected to know the ways of the locals.

The frantic pace at the hospital and the opportunities for interesting learning experiences also seem to temper Sherlock's tendency to become irritated by small, everyday things that don't work like they do in London. For his sensory issues, the climate still poses a challenge: heat and the associated sweatiness can drive him round the bend, and nights are particularly difficult due to having no air-conditioning. Still, at no point has he fallen into a full funk of homesickness. John would like to believe this is because, instead of concealing it when something is bothering him, Sherlock has begun to come to John with his worries and irritations. Instead of acting out, he seeks company and empathy, and John relishes the opportunities to make up for those moments in their past when he had not quite understood what it was like to _be_ Sherlock.

The only thing Sherlock still constantly complains about is _nsima_ , corn porridge pressed into cakes. It is served at practically every meal outside their home, and Sherlock finds the texture utterly abhorrent. At least he doesn't have to endure it at home: after two weeks of Sherlock's trench war against this staple of Malawi diet, Louisa graciously began to serve him freshly baked bread instead.

It seems that here, free of his past, in a place where no one knows him by reputation, Sherlock gets the fresh start he has always wanted. Here, he doesn't automatically assume everyone is always intent on hurting him, so he doesn't feel the need for pre-emptive strikes. Sometimes he even seems to forget himself, let his guard down, and behave a bit like he usually only does with John. Two days prior, John had spotted him making a silly face at the local children peering through the OR window as he was finishing up the operation on a broken Achilles tendon of a local farmer.

On a Monday night, over dinner, John manages to get his partner to answer some questions about his medical school years. The off-hand way in which he explains how he'd been treated by his peers and even some of his teachers breaks John's heart. But, when Sherlock shifts the topic to their work here in Malosa, the dark clouds in his expression instantly evaporate.

"Here, I am the _obwera_ ," Sherlock explains, using a Chichera word for _'foreigner_ ', "I am assumed to behave differently and strangely. At work, I am revered for what I can do instead of being constantly belittled for things that have nothing to do with neurosurgery. Outside of work, everyone here takes me at face value and assumes that I am likeable. It's very odd."

John understands what he means. The best example may be Louisa. She serenely takes in Sherlock's occasional tantrums and strops, going about her business clearly fondly amused by the two Englishmen trusted to her care. She's even begun to teach Sherlock the local dialect, which is already proving useful at work.

"You're not listening to me," Sherlock says indignantly, dragging John out of his thoughts.

"You _are_ likeable," John hastens to assure him. "That is, when you're not deliberately trying to chase people off."  
  


  
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Time off is a rarity when it's their turn to run the hospital. In the beginning, John had had to nearly force his partner to take some time for R&R, but once they found a routine, they both began enjoying their stay much more. Sherlock's boundless energy and enthusiasm are infectious, and the strict dichotomy of work and free time simply doesn't apply here.

They share a meal when they have time and return to the hospital when someone knocks on the door in the evening to summon them. In Malosa, nobody counts working hours here.

The animal life in the area is fantastic: there are big cats living in some of the country's nature reserves, bushbucks and klipspringers keep tearing across the roads, herds of elephants inhabit the wetlands... An African marsh harrier has made a home in a tree in the Hauglanders' garden, and Åse feeds it the vermin that have been trapped by their housekeeper. When things are quiet, or Åse and Jens-Erik are in charge, Sherlock and John sometimes set out in the hospital's banged-up jeep to discover what lies beyond the Malosa area. On one memorably outing, they went to see the elephants roaming the area close to Lake Chilwa, which requires a detour to a local army outpost where one can usually find a bored soldier willing to accompany visitors with their rifle and local knowledge for an afternoon for a generous tip. After their first work week, the Norwegian couple had taken them to an area called Chilema, where a single tree looks like an entire forest.

Getting out of the Zomba district requires a hair-raising flight back to Lilongwe aboard the Nyassa Air Taxi, but they have still already taken one mini-holiday, first heading to a game reserve in Northern Malawi and then to Victoria Falls in Zambia. Jens-Erik, who is a keen amateur geologist, has spent many an evening hunched over his mineral collection with Sherlock, introducing him to the region's specialities. Meanwhile, John and Åse have often gone to sit out in the garden with bottles of local beer, chuckling with their shared amusement over their husbands. The beverage, called _Chibuku_ , comes in cartons proudly announcing itself to be an ' _international beer'_ and instructing its drinker to _'shake-shake_ ' it before consumption.

   
  


-o-0-o-0-o-0-o-0-o-0-o-

  
There are bad days, of course.

Sometimes those days are even terrible days, such as when they lose a three-year old patient to what is likely bacterial meningitis. The family had first taken the child to a local witch doctor to exorcise ancestor spirits which they thought were causing the neck stiffness and convulsions. They encounter underage victims of sexual assault, mentally ill patients hidden by their families until they get physically ill, diseases which in the West could be cured but here, they mean a death sentence. It's hard to even believe such a thing could happen in this day and age, but one day a young albino man is brought in after being kidnapped and nearly strangled to death before his family managed to rescue him. The government has even considered reinstating the death penalty to curb attacks on albinos. Their body parts are sold for witchcraft.

When, for John, things turn into a soul-gutting struggle between cynicism and hope, it is Sherlock's ability for calm rationale during nearly any work-related challenge and tragedy which helps them both past all the despair and frustration. For Sherlock, it seems to have become a given that not everyone can be saved, and that everything they do is better than nothing. He seems be much better than John at stepping back when medicine simply falls short of being able to delay or prevent death.

There are also tragedies that turn into triumphs with their combined efforts. On a stormy night, a banged-up truck screeches to a halt in the middle of the night in the hospital courtyard. When the two doctors climb to the back to examine the patient, they discover a woman in labour with a foetal hand and the umbilical cord already born. The woman is in agonising pain, feverish with a likely infection, and John and Sherlock both know in an instant that there is no way for either mother or child to survive without a Caesarian section. This isn't a normal presentation or a manageable breech—umbilical cord prolapse with a sideways presentation could suffocate the child _and_ rupture the uterus.

Sherlock is white as a sheet when they wheel her into the OR. He has done a dozen Caesarians but only three without Jens-Erik's supervision, and none of them have been this urgent, or with this presentation.

Since a general anaesthetic in a labouring woman always poses greater risks than a spinal, John administers the block with a needle he is forced to reuse since they have, again, ran out of such supplies. At least it's been boiled by the nurses after being used for the first time. As soon as the block starts kicking in Mwiza, the OR nurse on duty, washes the woman's stomach with a carbolic soap solution and begins draping the surgical field.

After hooking up the anaesthesia monitor which is, thankfully, working today, John pulls Sherlock into the hallway. He'd been watching the preparations with an alarmed expression. He had also been very quiet, which isn't like him just before an operation.

"I've done only three breech sections with Jens-Erik, and this is----" Sherlock trails out, glancing around John towards the OR.

"Without us, she has no chance," John says, trying to infuse into his tone a calmness he doesn't really possess. "Whatever happens, we have to try. Any outcome is better than giving up now, out of fear."

John has been in such situations many times before—ones with only risky options. But, as long as there _is_ an option, something can be done. This is what he can do for Sherlock due to his past experiences of medicine in tough spots: help him get past the initial shock of what he is facing.

"Who knows, maybe we'll get a new goat out of this," John jokes, and as utterly imbecilic and morbid as it sounds, it seems to break the logjam in Sherlock's head. His shoulders square just a little, his eyes narrow, and he takes a deep breath.

John knows that look. Sherlock looks exactly as he does at King's just before swinging open the OR doors and taking his rightful place next to the patient's head holding the scalpel.

John goes back to the OR to make sure the block has spread wide enough. Within minutes, Sherlock is holding a scalpel, and the focus he had found hasn't wavered. From the first incision, it takes only three minutes until the baby is born. After some vigorous rubbing by Mwiza the girl finally coughs, her limbs pinking up and her initially worrisomely floppy muscles tense up as she begins to breathe properly and even tries to cry.

By the grace of some African deity and the skills of a British neurosurgeon, the mother and her infant both survive the night. Neither John nor Sherlock suggest leaving the hospital before the first rays of the sun begin licking the hospital roof.

They don't get a goat out of their feat, but three chickens instead—which are tactfully gifted back to the family a week later by Louisa, their trusted cultural consultant. The baby’s mother will need the protein from their eggs to recover her health.

  
  
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At the start of their nine months, they had promised that they would lean on each other when things got tough when things get tough. That promise hasn't been forgotten but sometimes the exhaustion, the stress, and the unfamiliar surroundings get to them, just like things get to them in London. Sometimes, couples bicker. Sometimes, they argue.

Sometimes, wherever they are, they have massive fights. Such as the one that starts when John dares to voice his frustrations that Sherlock expects him to sort out every practical problem that isn't directly related to work.

Now, Sherlock has draped himself bonelessly into an adirondack chair at the opposite end of the kitchen, and his histrionic sighs are driving John round the bend. "You're the one with the long fingers so why am I doing this?"

"You're good at it."

"Good at what? Shoving my digits up a disgusting, plugged pipe?"

"Right now, I'm wondering where my Malawi Sherlock has gone to, because obviously, the London one has taken his place."

"What's that supposed to mean?" Judging by the sound, Sherlock is scraping a jam stain off the dark wooden table with the butter knife left on it.

John is also certain that he's being glared at.

"I need this rain to _stop_ ," Sherlock moans. "My skin is crawling with it, I can't sleep, I can't concentrate––"

"Then _do_ something. Get your mind off it." John finally manages to dislodge whatever had been plugging up the pipe and gets a bit of water sloshed onto his face as a reward.

"I'm not you. I don't find any sort of meditative quality in menial tasks, which is why I don't bother."

Today, Sherlock has been complaining all day about this and that, about the rain making it impossible to have dry clothes, about the bugs crawling over his notes in the study, about the food and the thread count of their sheets and his boredom since it's their day off. It has been grating on John's nerves, and since those nerves can only be stretched so far, he finally snaps. At the hospital, Sherlock's inventiveness and work ethic are admirable but at home, John feels as though he's expected to do everything. He closes the cupboard under the sink and grabs a dish towel to dry his face. "The reason you don't bother is that you're a lazy git who likes to keep me around to do all the stuff you can't be arsed to touch. Malawi, London, nothing changes; you are spoiled by having others to do your dirty work. Once a kept man, always a kept man."

When the words _'kept man_ ' tumble out of John's mouth, Sherlock's jaw drops as his eyes go wide.

Sherlock is off the chair in a heartbeat, glaring at John. His expression is bordering on melodramatic, and John recognises he's just been insulted in a manner that has hit home.

"Out here, we work harder than we ever do at King's so I, for one, would like to just read a damned book and enjoy a quiet day," John growls from underneath the sink where he's still trying to screw a bolt back in.

Sherlock opens his mouth, then simply exhales sharply through his nose, and marches out, taking the front steps two at the same time.

John gets the bolt in place, then rolls his head back, relishing the cracking he feels from his cervical joints.

 _I shouldn't have said that._ It doesn't really bother him that much, looking after someone who is genius when it comes to medical research but lacks the cognitive execution capacity to remember to do the dishes. Sherlock doesn't neglect these things deliberately—these things simply don't occur to him. He might be standing next to a pile of overdue laundry, genuinely wondering why he can't find a clean pair of socks. Once, these things drove John to the edge of insanity, but now he knows that only some of it is due to Sherlock being unaccustomed to domestic routine. Most of all, it's because his brain prioritises different things.

 _He'll huff and puff for a while and then come back._ This is not the first time Sherlock has stormed off, and if he goes for a long walk as he tends to do at such occasions, he'll come back more relaxed. His brain may work differently to John's, but he's not immune to the effects of a bit physical exercise on brain chemistry.

 

-o-0-o-0-o-0-o-0-o-0-o-  
  


  
For a few hours, John relishes the chance the quiet house offers him to continue his John Le Carré novel in the hammock on their back terrace. Louisa serves a simple but lovely bean casserole with bread and fried okra, and John cracks open a bottle of wine some earlier occupant had left behind.

"Mister Sherlock not eat?" Louisa asks, hesitating to remove the pristine plate in front of Sherlock's usual seat.

John looks at the grandfather clock in the corner of the dining room and realises Sherlock has already been gone for three hours. The cicadas are getting louder, and it'll be dark soon. The pitter-patter of rain has been quiet this afternoon and it's oppressively hot, so how far could he have walked?

There is nearly no crime at all in these parts towards foreigners, so walking down the road should not carry much danger from people, but what about animals? Their mobile phones don't work out here so there would have been no way for Sherlock to call for help if he needed it.

John puts on his leather sandals and walks to the edge of their property. Mrs Sembereka, their neighbour who is a widowed schoolteacher, is picking mangoes from her garden tree. No, she hasn't seen _Mister Sherlock_ , as their neighbours call him.

John returns to the house. Without any knowledge of which direction Sherlock had stormed off to, it's pointless to go wander around looking for him.

John realises that it's as easy to disappear out here as it is in London. Sherlock can look after himself, and he's even picked up a few words of the local language to get by. Still, why would he stay out after dark?

Where would _John_ go, if he needed to cool off? He doesn't assume that Sherlock would make the same choices, but it's not as though they are both familiar with all that many places in the area.

The house is quiet and dark when he gets back in. Louisa has left, having finished packing away the leftovers and doing the dishes. John turns on the lights in the foyer and their bedroom, worry constricting his chest.

He's startled when the landline rings. John hopes it's not the hospital, calling them in to help with something urgent. He also hopes it's not the police, informing him that something has––

"It's Åse," a cheery voice replies to John's tentative hello.

Whatever she's calling about, John is grateful to talk to someone familiar. "Hi, Åse. Um, you wouldn't have happened to see––"

"Sherlock," she instantly offers, "He asked me to call, said you'd worry otherwise. He's here."

 _Oh thank God_. John pinches his eyes shut. _He's a grown man, I shouldn't worry so much. Of course he'd go to Jens and Åse._ John is a bit embarrassed, now—for what he had said, and for getting so worked up over the fact that it's past twilight. Still, there are lots of traffic accidents in these parts since people don't really acquire driver's licences before they buy cars and there have been reports of hyenas attacking people, even killing them–––

"He's okay?" John asks.

"I think so, yes, Åse replies slowly and thoughtfully. "He walked all the way here, he said, but he didn't say much more. Jens gave him some whisky; he's in the bath, now."

The Hauglands have a much bigger water boiler, enabling them to have a proper indoor bathroom with a small bathtub. In their house, all they have is a jungle shower in the back garden.

"He loves baths," John thinks out loud.

Åse is quiet for a moment before replying. "He was a bit… I don't know, John. But I think it's alright, now."

_A bit what?_

"I'll come pick him up," John says, digging around the desk drawer for the jeep keys.

"I can drive him home," Åse offers.

"No, I––I'm on my way," John announces and rings off.

  
-o-0-o-0-o-0-o-0-o-0-o-  
  
  


_'Some whisky_ ' turns out to be quite a significant amount, judging by Sherlock's glassy eyes when John enters the bathroom after knocking politely on the door.

There are old, dusty candles burning on the window sill, a fluffy, rolled-up waiting on a chair by the window. Sherlock's arm and one leg are hanging out of the tub and his neck is bent back against the edge.

John grabs a low, wooden stool from a corner and sits down next to the tub, leaning his elbows on the rim.

Sherlock’s response is to close his eyes. "You didn’t have to come. Åse would have driven me home." He's slurring his words a little.

John's initial estimate of his level of inebriation is confirmed by an empty glass and a small, half-empty bottle of Famous Grouse next to the tub on the floor.

Sherlock’s expression gives nothing away. Is he still upset? John can’t tell, so he sighs. "I know, but I want to be the one to do that."

Sherlock sinks his dangling limbs back under the foamy water. John can't help but smile at the familiarity of the sight; at home, Sherlock frequently takes baths both on his own and together with John, since their tub at home is big enough. When he was in a halo, baths were one of the only things that offered any respite from what he had described as constant sensory torture.

"Why?" Sherlock asks, "Because you think I expect you to wait on me hand and foot? Have a change of heart and now you suddenly feel like ssserving your _kept man_? That's not even accurate, by the way, sthince you're not the one who earnths the most and I’m certainly not at home all day doing nothing but keeping your bed warm…" The sharpest edge of Sherlock’s diatribe is dulled by the whisky. He has the slightest lisp when inebriated, and it always makes John smile because Sherlock is totally oblivious to how cute it makes him sound. John has not mentioned this, because that fact makes it quite difficult for him to take his partner entirely seriously when he's drunk. Sherlock is aware of his lisp in general, of course—to the extent that John has deduced it must be the reason he almost never drinks. 

"No, it's because I'm sorry for what I said," John replies firmly.

"You weren't listhening to me!" Sherlock says. "I tried to tell you why I hate the rain and you disthill–– _disthmissed_ me! You told me to calm down and sit down and do something. You have no idea how many times I’ve heard that same little chant thrown at me by my brother or parents. By now I would have thought…" He runs out of material for a moment, then splashes the water with his left hand in frustration.  "I can't, there’s no way to turn it off. I can’t play the violin because it’s thousands of miles from here, I can’t go anywhere, there’s nowhere to hide. not when we're at the hospital because there's something going on there all the time, people need us _all_ the time from the second we walk in until we drag ourselves out the door and is there any point in us even being here when the amount of patients is endless and it's like trying to plug a hole in a dam with a finger. I can't just sit around reading a book, John, I can't, and if I can't relax then I pay attention to all the things I should ignore, and it didn't work today, and you wouldn't _listhen to me_."

He’s working himself up into a right state, but John lets him vent because this is what he had been trying to communicate this afternoon when John had got cross with him. He can hear that Sherlock is close to the edge of tears; John feels his pain and knows that he is in part responsible for it. So, he gives his husband space to say whatever he needs to say.

"I’ve been trying so hard, and then you just said I was being a spoiled brat. I walked for miles, but it didn't help because it was raining, and I wanted to rip my clothes off and scratch my skin off and everything got _loud_." Sherlock pinches his eyes tight, breathes deeply, swallows. "I was so alone. I didn't know where else to go."

 _You could have come home, you idiot_. Then again, John can't blame him for not doing so. The things Åse had said and what Sherlock has just explained sound like sensory overload and the resulting inability to put into words how he was feeling. Maybe that's why he'd picked the candles over the ceiling lamp.

"Did the whisky help?" John asks, picking up the glass and the bottle and placing them on a small table by the window.

"It just postfon––postpones things," Sherlock mutters. "The bath's better."

"I'm glad you asked Åse to call me. I got worried."

Sherlock doesn't reply, simply lifts his hands from the foam and inspects them with a frown. His fingertips are wrinkled. "You're annoying when you're worried. You become an _insessthant nag_."

"I'm sorry," John says again. "I should have listened. It's just that sometimes it's hard to tell when you're just being a right arse because you're bored, and when you're trying to tell me something."

"I am the same here. I'm the same person," Sherlock says, watching a candle flicker in a draught from the window. "Why would I be different? Don't you like me in London? Do you _want_ me to be different?" He sounds miserable.

John places a hand on his wet shoulder, but he pulls away with a flinch and slides deeper into the water, rubbing the spot John had touched. He must still feel over-sensitized and annoyed.

John sticks his hands in his pockets. "No, I don't. You are the same person I love enough to marry and spend the rest of my life with, you berk," he confirms, "But it is interesting that out here, it seems to me that you are more comfortable being even more yourself than you ever are at King's."

"More myself? Is the self a quantifiable variable? Were you more you in Afghanissthan?"

"I meant that maybe, when we're out of our comfort zone, we shed some layers from the top which we use to protect ourselves. You're not as careful around people here as you are at home."

"Do you want me to be careful around you? Do I have to pretend? At home, it's a constant pressure to please everyone, to fulfil their expectations. Out here, the rules are different. Out here, I'm good enough because of who I am. The people here assume that those who aren't from here don't know the rules, so they are allowed more mistakes. My deficitscts get lost in the white noise of the white man's defects."

 _Surprisingly eloquent for a drunk Sherlock_. The man has no head for liquor since the most he ever drinks is a glass of champagne at parties or a couple of glasses of wine at a restaurant.

"But you don’t cut me the same shlack they do. You know the way I am. At home, I'll never be good enough because of _who_ I am. Because thanks to you, I can't esshcape being me even on the other side of the planet." Sherlock lifts his hand to point at John’s forehead, then pokes it once with his forefinger. "Right there. The label has been planted and no way I can shift it. You keep waiting for me to make the same mistakes I make at home," Sherlock accuses. "You're always positively surprised every time I manage. It’s depresshing."

"Not true," John insists. "Isn't it usually me who insists you can do stuff, that you shouldn't give up, or repel everyone as a preventative measure?"

It's been a while since they last discussed these things. Even skirting the edges of the social difficulties associated with Sherlock being on the Spectrum is a sensitive subject.

"Out here, people don't need explanations for the way I am. They lump me together with other Westerners. I _pass._ "

"And you like that?" It all makes sense to John, now.

"Yes," Sherlock decides, and sticks his toes out from the water. “I don’t need to prefec…no, that’s not the right word.”

John watches tiny creases appear on either side of Sherlock’s eyebrows, and decides that his tipsy husband is being rather adorable even if he could never say so out loud.

Sherlock’s face lights up, and he slurs out, " _Pretend_ —that’s it—to play by other people’s rules if I want to avoid being called names.” He giggles. “Out here we are _all_ tarred with the same brush; we’re all just _obwera_.”

Sherlock bends his knees, so he can slide down the bath and lower his head under the water for a moment. He comes up a moment later, blowing out the breath he'd been holding.  “They think you and I are both weird. For once, at least in their eyes, I am your equal. I like that.”

"Anybody would," John confirms.

"Out here _you_ ––" Sherlock says, now poking the tip of John's nose with his forefinger. He manages to hit it after a few tries and starts emphasizing each word with a poke. "––are a _freak_ , too. Weirdo. _Ti ndiku ku funa kuno,_ _white boy_!" He flicks his wrist dismissively towards John.

"I'm not the white boy who gets sunburnt even through curtains," John teases him back.

"Before you marched in here I thought that maybe, if this is the worst that I can feel when we're out here, then it's not _that bad_."

"We've been through quite a lot already. I think we've seen the worst," John confirms. "And neither of us has wanted to run away screaming."

"It's not a matter of wanting to leave but wanting to stay. London is home, but sometimes one sees best from a disthance."

"I really am glad you're finding Malawi tolerable."

"I didn't come here expecting everything to be terrible. But you thought I did?"

"No, of course not."

"I didn't expect everything to be easy, but I wanted to get through it, prove to myself that I could, no matter what happened."

Sherlock starts climbing out of the bath. "I wanted you to be proud of me, too."

His expression crumples. "But you’re not; you think I’m too used to everything being as London-easy as things can be, for me, that I can’t cope, if I don't have the things––that way," he concludes.

 _'London-easy_ ' is a brand new non-sequitur for John, who grabs the towel and holds it open. "Not at all. You've made it look like some things here have been easier for you than they have been for me, and that has impressed me."

"Processing—no, wait; that’s not right either? Pro _jecting_ your expectations that everything was going to be hard for me, perhaps when I do a few things right, then you are surprised. Thath’s faint praise." He leans against the wall, balance clearly affected by the whisky.

“Don’t over-dramatize this," John tells him. "I just never know what to expect with you, which is great because it keeps things interesting, but it also makes it damned hard to predict when I have to support you. It’s kind of weird: you deal with stuff here that I never thought you would: meatball surgery, untrained staff, an OR that is unhygienic, under-resourced, over-worked and puts you in the position of making impossible medical snap decisions.” John laughs, a little self-consciously. "You’ve risen to the challenge amazingly well. It’s unrealistic of me to think that you’d suddenly develop an appetite for domestic chores and primitive plumbing along the way. Don’t let my being peeved with the living conditions and losing my temper when I got a face full of drain muck make you think I am anything but proud of you."

"Why do I need you to be proud of me?" Sherlock's brows have knitted together so tightly it makes him look a bit cross-eyed. "Why do I need anyone to be proud of me? Can't I just…be?"

"Good questions, but ones best considered when sober." John gives him a brief hug after draping the towel around his shoulders. He then strokes his hand down the coarse fabric to rest on the small of Sherlock’s back. "Forgive me? It's a request universally translatable as ' _I was an arse and I should have done better'_."

The answer is given when Sherlock turns around and pulls John close for a deep kiss. When they come up for air, John is aware that Sherlock’s arousal is proof enough of his forgiveness.

"Accsheptacle," Sherlock announces, and unbuttons the collar of John's shirt.

John is highly tempted to reach down to stroke that cock—both to coax forth an even more intense arousal and to be gentle—to make further amends with a bit of intimacy.

"You could suck me off," Sherlock suggests, wobbling a bit as he reaches down to recover his polo shirt and damp shorts from the floor. "I would currently probably enjoy it."

"And Åse and Jens would _currently_ _probably_ hear us," John counters, chuckling at Sherlock's strange drunken grammar.

If Sherlock is thinking about sex, the bath and the whisky truly must have helped with what could probably have led to a sensory meltdown. And, getting all this out in the open seems to have taken the steam out of their argument, too.

Sherlock wraps his arms around John's neck again, buries his nose under his ear. "I missed you. Let's go home. I want make-up sex."  
  


  
-o-0-o-0-o-0-o-0-o-0-o-  
  


  
There is no make-up sex that night, because once they get back to the house, Sherlock goes out like a light without even brushing his teeth.

In the morning, however, they both wake up with morning wood which effortlessly turns into lovemaking. When the first rays of the sun reach their bedroom, John places a steadying hand on the rippling back muscles underneath him and picks up the pace of his thrusts, certain that he's employing enough lube to avoid chafing. Having come already, Sherlock is lost to the world, turned into a pliant and boneless creature uttering the occasional random grunting nonsense and repeating John's name. After climaxing, he tends to become inordinately sensitive, and the sounds he makes then are just the thing to push John over to his own finish.

He grimaces as his muscles clench and a violent shudder runs through him as waves of orgasm hit, leaving him panting since his lungs had been squeezed empty by the pleasure. Slamming his hand back on the mattress, keeping his upper body raised, he presses his groin tightly against Sherlock's buttocks, relishing the feeling of being joined and so close, warm and deeply intimate. He's getting soft but is reluctant to pull out just yet even if it means taking extra care to hold on to the condom when doing so. At home they don’t use them but here, the shower situation being what it is, minimising the mess has become a priority.

The mop of curls in front of him shifts as Sherlock extends his arms above his head into a languid stretch. John lowers himself down so that his chest is against his partner's— _husband's, still a new and wondrous thought_ —back that's glistening with sweat. He slides his hands up Sherlock's arms, kissing his neck through his hair.

Sherlock makes the strangest sound—one John has never heard before. He stifles a laugh, knowing that the man underneath him is very self-conscious about such things. It's always been hard for him to let go completely, to allow John to see him at his silliest, at his most embarrassed, at his most human.

The sound repeats, but this time it somehow sounds as though it had come from behind them. John slides down off Sherlock's back, and gathers his legs so that he can sit up properly.

He turns—and comes face to face with two tiny, black eyes in a head tilted inquisitively.

"Sherlock?" he whispers and gets an abstracted whiny hum as a reply; John is certain his partner is about to fall into a blissed-out sleep. "Sherlock!" he tries again, not sure why he's whispering loudly instead of just talking, because their intruder clearly isn't spooked by the much louder sounds it may have already heard.

A head of messy curls rises, and Sherlock turns his head in John's general direction. He hasn't bothered to even open his eyes yet. "What?"

"There's a chicken staring at me."

Sherlock yawns and cracks open his eyes, his left hand performs an absent-minded tug at his cock as he gathers himself up into a sitting position; maybe it had been trapped in the seam between the two single-person mattresses on their double bed. _Damned Scandinavians_ , John thinks every time they have to push them back together after a restless night or a round of sex pushes them apart.

"That's the same one that keeps coming to all the houses down this road," Sherlock explains as though he's talking about an old friend. "I told the neighbour who owns her to build a pen but apparently nobody does that around here. This one just won't stay in their yard."

"Chicken have fleas, Sherlock. I don't like that she may be hanging out on our bed."

"The damage is already done. She's quite tame." He stretches out a hand and the chicken scoots closer, arching her neck for a scratch.

The past months have made John realise how much Sherlock likes animals. There are plenty of friendly dogs in the village, to which he secretly feeds scraps of his lunch when the hospital guards aren't looking. There's also the astounding amount of knowledge of the local wildlife he had amassed before they had even arrived.

Now, he's petting a chicken. One he has apparently befriended.

John shakes his head and crawls off the bed to grab his dressing gown. "Have you ever had a pet?"

Sherlock shakes his head. "Mycroft was allergic to dogs and my mother loathed cats. I did bring home whatever I could find in the fields around us, but understandably my mother was not keen on me keeping field mice or snakes in my room. There was a farm near us where the owner let me help out with his horses. He had two Clydesdales a local brewery paid him to look after; they were used for promotional things. He died of a heart attack; unmarried, no close relatives, quite a lot of debt. The bank sold the farm and the horses."

Sherlock's tone is thoughtful—bitter, even. He grabs the chicken, grasps it firmly between his arm and his side, and slides off the bed. "I'm taking a shower. Might as well return her to Moses while I'm at it."

"Don't talk to the neighbours without your pants, love," John calls out after him and soon Sherlock strides back to grab his clothes, the chicken under his arm looking cosy and content.  
  
  


**Notes for the Chapter:**

> Attacks on albinos? [Fact](https://www.voanews.com/a/malawi-debates-death-penalty-attacks-albinos/4363063.html). [Both children and adults are at risk](https://www.amnesty.org.uk/ritual-murders-people-albinism-malawi).


	9. Lost Time

  
  


> _One does not make a shield in the battlefield._  
>  —Malawian proverb

  
It starts with a hangover. At least that's what they both suspect at first, since the night before, they'd enjoyed a nice meal at Åse and Jens-Erik's house. The Norwegians were in a very good mood: now that John and Sherlock have settled in, they could start planning a much-anticipated trip to Norway. A bottle or two of a nice Sangiovese was consumed, and John hadn't paid much attention to how much of it he had ingested. They'd stayed the night, so he didn't have to worry about driving. He consumes much less alcohol here than he does in London, so it had seemed logical that his head for booze might have weakened.

After a change of clothes, an extra cup of tea and a paracetamol at home, John drives them to work, feeling oddly bone-weary as he negotiates the morning traffic in the village. Farmers are heading to the market with their wares, women are carrying water, children hurrying to school. Sherlock has his arm hanging out of the jeep window and he has closed his eyes, his curls gaining an almost auburn tint in the morning sun. He fusses with them much less here than he does at home and there are messy ringlets hanging on his forehead. John thinks the look makes him appear younger, boyish and almost painfully handsome.

Once they arrive at St Mary's, Sherlock heads upstairs to round the surgical ward, and John goes to the OR floor to see what the night has brought in terms of urgent surgeries. Jens-Erik had stayed sober last night so that one of the four doctors could head in if there was an emergency, but the hospital hadn't called even once. Must have been a quiet night, John thinks as he looks at the board: only an ankle fracture has been jotted down on the chalkboard. He checks that the patient has been kept nil-by-mouth, administers a spinal and then spends most of the operation resting his eyes sitting in the corner of the OR, leaning against a sun-warmed wall. Despite the already sweltering heat, he feels chilly and almost tempted to wrap a blanket around his shoulders. By the time Sherlock has finished his quick, cursory round and plated the ankle, John is forced to admit that his now profound sense of malaise is not a hangover and by lunchtime, an intense headache is throbbing within his cranium. He takes an ibuprofen, another paracetamol, and eventually a codeine tablet as well, but nothing alleviates the feeling of someone pressing hard on his eyeballs and a lead weight on his shoulders trying to buckle his knees. Taking frequent breaks, he manages to trudge through his afternoon rounding on the rest of the bed wards while Sherlock gets stuck at A&E arranging air transport to the capital for a patient with a head injury who John had stopped by to sedate and intubate after lunch. John is thankful that it's a rare quiet day; most of the patient beds are empty. It's harvest season, which explains why people are not flocking to the hospital to have old ailments looked at. There are always a few animal attack and traffic accident victims, but, all in all, it's been a welcome lull in the usually frantic pace of life at the small hospital.

At four in the afternoon, the two doctors reunite for a round of the small observation unit they are trying to establish. A proper intensive care ward would be utopia since they have no proper monitors available except in the OR, so even just a nurse sitting with the patients and taking their vitals old-school is a big improvement in the care of unstable patients. Halfway through the proceedings, John grabs a chair and collapses into it.

"I need to sit," he mutters, teeth clattering as he rubs his palms up and down his goose bumped arms. The meds had helped for a few hours, bringing on a shirt-drenching bout of sweating, but now the chills are back, and he feels just dreadful.

"John?" Sherlock puts down the hand-written chart detailing the progress of a multiple trauma patient who just might pull through, despite a pneumonia complicating his recovery.

"I'm freezing," John tells him. To echo his statement, a shuddering chill runs down his spine.

"You've taken your malaria tablets, haven't you?" Sherlock asks. He places a palm on John's forehead and then rests his fingers gently on his neck, watching a wall clock to count the heart rate per minute. "No prophylaxis is fool-proof, of course."

"Yeah, every day. Plenty o-o-other t-things around which can cause f-f-fever."

"There's no malaria reported in this area resistant to what we're taking. You were fine this morning, weren't you?"

"Tired. A bit achy. Thought it was the w-w-w-ine," John replies, trying to keep his voice steady but he's now downright shaking with the rising fever, teeth clattering like coins on the bottom of a pocket.

"Do you want to head home? You could wait on the terrace; it'll be warmer in the sun, and I could wrap things up here?"

"Yeah," John says, wanting desperately to lie down.

Despite the headache, he dozes off in an old, half-broken beach chair placed in the upstairs terrace doubling as a doctors' lounge after drinking a litre of water. He has no idea how long he sleeps, and only wakes up when Sherlock taps his shoulder.

"Can you drive?" he asks. "Or do I need to call Jens?"

"I think so." John climbs to his feet, and the headache kicks up a notch, suddenly making him dry-heave. A trip to a loo nearby brings nothing up, and he forces down half a small water bottle Sherlock fetches for him. Alcohol worsens dehydration, and he hasn't drunk nearly enough water today.

Somehow, John manages the drive back to their house without hitting anything or anyone. When he climbs out of the jeep his legs nearly give out with exhaustion. Sherlock grabs his arm and helps him up the front steps and through the house into their bedroom.

"Fan on or off?" he asks.

"I don't know", John says, burrowing under the sheet. He misses their bed at home—soft, with a heavy duvet to provide a reassuring warmth and weight. He feels filthy, sweaty clothes clinging to his limbs, but dragging himself to the back garden for a shower is not a realistic idea.

Sherlock brings him some water and the platter of sliced fruit Louisa tends to leave for them as an after-work snack. The fruit John only glances at because he's still nauseous, but while Sherlock momentarily disappears off somewhere, he downs half the glass of water before dropping his head back on the pillow.

"I'll instruct Louisa to prepare something light for tonight," Sherlock suggests. The mattress tips down as he takes a seat on it next to John.

John keeps his eyes closed since it seems to marginally help with the feeling of someone trying to jam a screwdriver through his eye socket. His back feels stiff and sore, his joints heavy like lead.

Sherlock takes his hand, turns it, grabs hold of a finger. "What're youd…" John trails out, lethargy dragging him towards a treacle-like haze in his head. He doesn't even bother to open his eyes.

"This'll prick a little," Sherlock says and true enough, something sharp pierces John's fingertip and he grunts in feeble protest.

"I'll do a fresh blood smear; there's a microscope in the study cupboard. Since you're feverish there should be malaria parasites visible after I add a bit of Giemsa which I grabbed from the hospital lab."

The words register in John's brain, their meanings do not. He doesn't know how long he lies in a shivering stupor before Sherlock deprives him of some of the bedding with which he has covered himself and sticks a thermometer in his armpit.

"Co-old," John protests the invasion. He's trying to lie very still, since even tossing and turning hurts. It's impossible to find a comfortable position when his muscles keep complaining even just from the pressure of a blanket.

Judging by the sound, it's raining heavily outside again, after a respite of two days. _Sherlock will be annoyed_.

The offensive object in John's armpit soon beeps.

"Feeling cold is logical, since you're at forty point two celsius," Sherlock announces. "I'd say more paracetamol is due."

His words are the last thing John remembers from that night.

  
-o-0-o-0-o-0-o-0-o-0-o-  
  


  
The next morning is equally miserable. Nausea builds up and takes over John in waves, forcing him to stumble back and forth between the loo and their bed. Finally, he gives up and curls into a ball on the floor of the toilet.

That's where Sherlock finds him God knows how much later. The ceiling light he turns on makes John yelp as the headache returns to its full glory. Eating or drinking anything is the last thing he wants to do, but Sherlock sits with him on the reed mat on the floor and helps him down mouthfuls of water with a sachet of rehydration salts dumped in. It's the one medication that's always available in copious amounts at the hospital for the care of children suffering from diarrhoea—a common ailment wherever safe drinking water is a rare, expensive luxury.

 _Maybe Sherlock had a hunch yesterday and grabbed some to bring home_ , John reasons before doubling over the toilet again.

Eventually, his stomach begins cramping even from the salt and sugar -infused water. He curses at Sherlock when he returns from the kitchen with a freshly filled bottle of the concoction. "––fucking thing away from me, not 'avin more of that." Trying and failing to sit up, he tilts towards the toilet seat and bruises his cheek on it.

Sherlock kneels by him, a silent statue of worry. He places the water bottle on the floor next to the toilet door, then climbs to his feet to go rummage around a closet in the corridor where Louisa keeps cleaning supplies. He finds a bucket, the handle of which he slips his arm through, then goes to help John off the floor.

"Back to bed with you," Sherlock announces. His grip on John's arm nearly slips off his clammy skin; sweat is pushing out of his pores, leaking down his forehead and down his sides from his armpits.

"Malaria," John gasps once back in bed. "It has to be."

At least malaria is treatable.

"I couldn't see any plasmodiums in your sample. Maybe the red cells hadn't burst and released them yet. I'm not sure at which point of the fever cycle that happens. I should have asked Jens. I'm redoing the smears at the hospital today, and the lab tech will need to have a look at them. He's seen more malaria than me."

Sherlock's description is generous. John is pretty sure that _neither_ of the two of them has ever tried to lab-diagnose malaria.

John realises he hasn't taken his prophylaxis today. It would have come up, anyway. And, if the diagnosis is confirmed he'll have to swap to another drug since this bloody bugger has broken through the prophylaxis.

"I won't leave until Louisa's here," Sherlock says.

"I'm not dying. Just go work out what this is and fix it, genius," John mutters.

Sherlock pinches his lips together, says nothing.

  
-o-0-o-0-o-0-o-0-o-

  
  
The next God-knows-how-many hours are a blur. When John finally manages to drag himself to wakefulness it has to be late afternoon, judging by the position of the sun. He can hear Louisa clattering about in the kitchen; there's a banana and a glass of what is likely to be guava juice on his bedside cabinet. His clothes smell of stale sweat and when he grabs the thin sheet covering his chest to reposition himself, he grimaces—his fingertips feel as though he had stuck his hand into a jar of thumbtacks. His knees ache, and his soles are sore as though he had hiked for days. He's too tired to sit up, too tired to reach for the glass on the table, though he's absolutely parched. A faint smell of vomit makes him peer over the edge of the bed, and he spots the bucket Sherlock had found with the bottom covered with sick he doesn't even remember expelling. _Must be the fever_.

His bladder is twinging with the need to void. Grunting with the effort, he sits up on the edge of the bed and makes use of the bucket from that position, tempted to mouth a pre-emptive 'sorry' to whoever will be forced to empty it.

Looking down at his aching hand holding his cock, he notices that his thighs and his arms have erupted in faint, red dots. On his stomach and chest, they are darker red, and after tucking himself back into his pants he presses his fingers down on an area where they are most plentiful. He's relieved to see that the redness evanesces when the capillaries react to his touch, and the rash doesn't itch of bother him at all.

John doesn't have that much experience treating patients with malaria, but he knows that a rash isn't a typical feature of it. He drops down, back-first, onto the bed, feet still dangling from the edge. Even just breathing deeply makes his chest muscles throb with a dull ache.

Louisa soon comes to check on him, replacing the now warm portion of juice with a fresh, cold one. The glass weeps enticingly, and John manages to clamber back to a sitting position for a moment to enjoy it. His reward is another set of stomach cramps so excruciating that he bites his lip to avoid whimpering. Louisa hears him, and returns to the bedroom, reassuring John that _Mister Sherlock_ is at the hospital but will be back soon. Åse or Jens must have driven him there.

A faint recollection of what Sherlock had mentioned last night about redoing the blood samples comes to mind. In his miserable state, John can't help hoping that he'll be back soon. He probably can't do much to alleviate these symptoms, but John still longs for his company.

"Hey Louisa?" he shouts, collapsing back into lying down and tugging at the crumpled sheet.

She soon appears in the doorway. "Yes, John?"

John lifts his T-shirt. _Should change clothes but too tired_. "Do you know what this is?"

Louisa nods. "Amanyong'onyeka," she replies with conviction.

"Sorry?"

She repeats the Chichewa word.

"Malaria?"

"No, Mister John."

"Okay." He closes his eyes and sleep takes over again.

 

-o-0-o-0-o-0-o-0-o-0-o-

 

There's yelling.

There's also pain, lots of it. John fights it with his fists, floats in it, tugs violently at the sheets and tries to claw at whatever is trying to burrow out of his head. His bones ache as though hot brands are being forced through them. The smell of old, coagulated blood flirting with piss, vomit, and sweat seems to permeate his consciousness even when he sleeps.

He sleeps like the dead when he isn't half-conscious and terribly confused about where he even is.

He remembers a familiar hand resting on his forehead, but even that hurt.

  
-o-0-o-0-o-0-o-0-o-0-o-  
  


  
He loses three days to feverish stupor and exhaustion. When a reliable sort of awareness finally returns, John finds himself in an uncomfortable bed in the annex of the hospital. It's old and rickety; there’s no way of raising its foot or the head, but at least the pillow is comfortable.

John recognises that he is St Mary's newest and cleanest ward, which isn't saying much. Oxygen prongs are tickling his nose but the bottle has probably emptied since he can hear no familiar hissing flow, there's an IV on his bruised arm and a urine catheter chafing on his sore nether regions. Light no longer hurts his eyes, the headache is gone, and this is a different sort of sweaty tiredness to the one he remembers experiencing at the start—this one makes sense. He's hot and clammy, not shivering with cold yet soaking.

He takes a moment to study the blotches of violet on his arms—they don't look like the result of being held down. Instead, they look like spontaneously formed ecchymoses. He draws a fingernail along his forearm, and underneath the skin, capillaries instantly burst into reddish blotches. There's something dodgy going on with his coagulation.

It's raining outside, and the smell of damp earth is pervasive even indoors. There is an open doorway nearby to the hospital courtyard. John decides he likes the smell; it's fresh and cooling and much nicer than the smell of antiseptic and sickness trying to mingle with it.

He's the only patient in the room. _The lull in patient numbers must be continuing._

He leans over the low bed rail to glance at his bag of urine. He's mildly alarmed to see that the contents are the colour of Earl Grey tea. _At least no blood_?

Footsteps approach, and John flops onto his back again.

"Hello, John," Åse greets him with a sunny smile, taking a seat on the edge of his bed. She's wearing scrubs, having probably stepped in to take over some of John's duties. Despite her specialty being public health, according to Jens-Erik she has often handled anaesthesia for his cases. She had worked in the field for several years when she was younger.

"Feeling better?" she asks, sounding as though she already knows the answer.

"I guess," John offers. "What's the time?"

Åse checks her watch. "Three in the afternoon…on Friday."

"What? When did I––" he trails out, realising that he doesn't even remember leaving their house. The last thing he recalls with any certainty is leaving work with Sherlock on Monday, feeling rotten, and the next morning when Louisa had seemed to know what this was. He never did get an explanation for the strange, complicated word.

He realises that the rash he had spotted is gone. Now, he just has the bruising and what appear to be petecchiae—pinprick-like haemorrrhages under the skin—dotting mostly just his torso and legs.

"Fill me in, please," John says, because it sounds more sensible than bombarding Åse with all the questions darting around his still sluggish brain.

"Sherlock called us on Sunday morning, saying he needed a ride to work. We went to the lab to do a blood smear, and it confirmed this wasn't malaria. You didn't have the rash yet, but there actually were very few options as to what this could be. Jens stayed in to run things here, and I took Sherlock back to the house. Louisa told us she'd told you that you had Dengue——"

"Dengue," John repeats. "Not what Louisa said."

"Amanyong'onyeka?" Åse offers, closing the roller on John's IV since the bag of Ringer's lactate dripping through has finished. "That's the Chichewa word for it."

"Right," John says, feeling a bit overwhelmed. "Yeah, I think that's what she said."

"When we got to the house, your fever had risen back up again, and you weren't coherent," Åse continues.

She then recounts the events of the next few days. As is typical for Dengue—an infection caused by a flavivirus—John's temperature had lingered in the high thirties and low forties for the next few days, making him delirious and utterly lethargic. Knowing it was typical of the course of the illness for which no specific treatment is available, the three doctors keeping an eye on him hadn't worried. At least not until his urine output dropped to zero, and the regular blood samples Sherlock was taking and ferrying with Jens' help back to the hospital began to show an alarmingly low platelet count.

"That explains the bruising and the petecchiae", John reasons. "Does that always happen with Dengue?" he asks, aware that many viruses, including influenza, can mess with platelet counts.

"No, it's not a feature of most cases I've seen, which have been mild," Åse says, and continues the story. At that point, Sherlock had become adamant that John needed to be taken somewhere with intensive care available, since the illness could have been progressing towards what is known as Dengue Hemorrhagic Fever. This form of the infection carries quite a significant mortality rate. But, the flooding in the area thanks to heavy rains had decimated the airfield, and the next closest one was behind roads also decimated by the flooding. They had been effectively stranded.

"So, we brought you here," Åse explains. "Sherlock tried everything, even contacting private helicopter services in Tanzania because we wanted to get you to Lilongwe. He also tried to do patient work at the same time, but it just wasn't feasible so Jens took over."

She tells John that they did what they could with fluids and medications, and somehow, his kidneys refused to entirely give up the ghost. This morning, the platelet counts finally began to climb up and his fever finally broke.

"You have both been through quite a lot," Åse concludes. "The airfield is still out of order."

"I'm sorry you had to come to work on your week off," John offers. Thankfully, their trip to Norway is still two weeks away.

Åse's quick and easy smile is genuine and infectious. "You know we don't make such a heavy distinction between work and time off. It's all just life." She stands up. "I sent Sherlock to nap on the terrace since he was nodding off where he stood; let me get him for you."

John opens his mouth to protest, but she is already striding towards the corridor that joins the annex to the main building.

Soon, there are running steps approaching; Sherlock must have sprinted down from the second floor. He skids to a halt beside John's bed, eyes wide and disbelieving.

John takes in the sight. He knows he can't look like much of a charmer right now, but his husband looks nothing short of completely wrecked. There are dark shadows under his eyes, his clothes which look as though they've been worn for several hand hang from stooped shoulders, and exhaustion has given him a sickened pallor, too. His curls are sweaty, matted, dishevelled, and he has at least three days' worth of facial hair.

"Doctor Livingstone, I presume," John jokes, "You look like shit, love," he blurts out next, so happy to see his husband that he can't even fully comprehend it yet.

Sherlock drops down to one knee, to frown at his bag of urine as he lifts it up off the floor. "At least a hundred and eighty millilitres in three hours; a thirty percent increase." His hand shakes a little as he gently lowers the bag back on the uneven concrete floor.

John wonders if he's been eating and drinking enough. Stress always decimates his appetite and self-care. He grabs hold of Sherlock's arm and gently tugs him back up to a standing position. "I guess I was really out of it. Åse says it's Friday already."

Sherlock bites his lip, looking anxious.

"I'm okay," John tells him, confused at his spooked demeanour. "At least I think so." He pats the arm he'd been holding, now hanging listlessly at Sherlock's side.

"We could continue monitoring you at home," Sherlock suggests. "The hospital's rat problem has returned, thanks to the flooding."

John reaches out for Sherlock's head, with a glance down inviting him to sit down on the bed so that he can place a palm on a pale cheek. Sherlock shoves a few errant curls out of the way with his fingertips, then shoves his hands between his knees.

_He does that when he's trying to hide nervous fidgeting._

"Hey?" John asks him. "Are you–––" he doesn't even get to 'alright', before Sherlock bounces to his feet, John's hand falling off from where it had perched on his shoulder.

"I'll get Jens. We need to go get petrol for the car," Sherlock mutters and walks out to the courtyard.

John stares after him, confused. He's been out of it for three days and doesn't even get a proper moment to enjoy Sherlock's company?

Åse soon returns with a protein drink John remembers being available at the local store. It doesn't taste very good warm, but it's safer than the meagre food the hospital has on offer. He certainly wouldn't want to catch a stomach bug on top of the Dengue.

The disease is sometimes called _breakbone fever_ , and John can understand why. He's had the influenza once, in London, but that paled in comparison to what he's been through. He still feels as though someone had driven over him with a truck—every muscle is sore and weak and his back is stiff and achy. He doesn't even want to consider how exhausted a trip to the loo would make him, and he doesn't even know where the nearest one is.

Jens pops down to see him, and he and Åse tell John that they will look after the hospital while he convalesces. Neither says so directly, but John reads between the lines that they think Sherlock needs some R&R time as well.

After the petrol run, Sherlock oversees operation let's-get-John-home with the iron fist of a war general. He's being a good sport, but John can spot the signs that he's completely drained: the constant, varied, subtle stimming, the distracted and snappish demeanour, the haunted look, and the way he keeps repeating instructions in an attempt to make things happen faster.

Uncharacteristically, Sherlock thanks Åse and Jens politely and profusely after the three of them have deposited their patient at home in a bed with fresh sheets, courtesy of Louisa. He lingers in the background as the others fuss over John: Åse brings an old coat rack from the foyer to act as a makeshift IV pole, and Jens makes sure the medicine box is stocked with anti-emetics and paracetamol—anti-inflammatories such as ibuprofen are now contraindicated since John's kidneys are still recovering.

The bliss of a familiar, comfortable bed with fresh sheets helps John delay his desire for a shower and a change of clothes. _One thing at a time._ He'll try to muster up the energy to have a wash tomorrow. Now, he's content to just sprawl across the bed, close his eyes, and relish the fact that he feels a hell of a lot better than he did before his memory spluttered out like a faulty light bulb.

After having some sandwiches in the dining room, the Norwegians and Louisa start preparing to leave just as darkness begins to creep in to shroud the trees outside. John listens with half an ear as Sherlock delays them with repeated questions about this and that—as though he's afraid of being left alone with John in the house. Louisa is the first to leave, and then Sherlock walks their guests to the Norwegian's car, but his footsteps never return up the creaking steps to the front door.

John rests for a moment more before slowly sitting up. A couple of moths collide with the window, attracted by the lights in the bedroom since it's now completely dark outside. John thinks he hears steps on the back terrace, but not inside the house. What is Sherlock doing out there? He sometimes watches the bats and listens to nocturnal birds in the front yard after sundown; doesn't it occur to him that John would really like his company tonight?

Grunting with the effort, John clambers off the bed, grabs a colourful woven throw they rarely use from a nearby chair and drapes it across his shoulders—more for comfort than for warmth since he is no longer feverish.

It can't be more than thirty steps to the dining room, but even that drains John's energy completely.

At least he's found Sherlock, whose whereabouts are betrayed by a shadow cast by a tall figure in the lantern light on the back terrace. He must be deep in thought since he doesn't seem to register John's approach; all the wooden floors make enough noise that it's impossible to move silently in this former residence of local missionaries.

The only sounds coming in from the terrace are those from the cicadas and a tambourine dove residing in a yellow cassia tree at the edge of the property. Sherlock has wrapped his arms around himself tightly and his head is bent slightly downwards where he stands by the balustrade, facing away from the house. One palm seems to be held close to his face, and his shoulders are shaking.

John pads to the where the dining room meets the terrace, and quickly slips through the net door. "Sherlock?" he calls out.

Sherlock freezes mid-inhalation, doesn't turn to look at him. Slowly, he lets out a ragged breath, drops his hands and plants his palms on the balustrade, fingers curling tightly around it.

Every step requires energy John doesn't really have, but he still shuffles to where his husband stands, suspended in tense silence by something John can't quite yet decipher.

"You should be resting," Sherlock says, and his voice is congested and strained.

"So should you, judging by what Åse said when she filled me in on the last few days. Come to bed," John coaxes.

"What did she tell you?" Sherlock still won't look at him.

"That it was a close shave, that you tried to get me transported out."

"Translation: I was useless."

"What? No!"

"I should have called Mycroft, he has connections; it didn't occur to me to look at platelet counts earlier than I did even though it was so _obvious_ ; I should have taken you in earlier, but I didn't think we could do more at St Mary's and I shouldn't have left you here alone–––"

"You quickly worked out that it wasn't malaria. Dengue doesn't have specific treatment, it's all just supportive."

"If my base knowledge of tropical infections hadn't been lacking, I would have known before your condition deteriorated that the criteria for Dengue Hemorrhagic Fever include thrombocytopenia, circulatory shock, active bleeding, cognitive symptoms, potentially requiring supplemental oxygen, blood products, invasive monitoring of blood pressure, dialysis, mechanical ventilation and complications include seizures, thromboembolic events––" This is listed in near-manic monotone.

"Sherlock––" John says in a warning tone and drapes an arm around the stiff shoulders in front of him.

"––Heart damage, liver damage, brain damage secondary to circulatory shock or viral meningitis, de––"

"Shut up!" John commands and shakes the shoulders he has dug his fingers into. "Shut up, you brilliant bloody idiot and come here," John says, his tone now softer and lovingly berating. He gives Sherlock's left shoulder a gentle shove so that he'd turn around and is relieved to see Sherlock's death grip on the railing loosen. He looks down once they're face to face, presumably embarrassed for letting John see his puffy, red eyes—evidence of how upset he'd been just minutes ago.

Under John's gaze, something finally cracks in Sherlock's demeanour and he takes a step into John's arms. His palms find John's chest, his left flattening right over the apex of the heart. "If you got worse I didn't have any of what I needed available and you did get worse and I didn't know what to do–––" his voice breaks.

John shushes him, slides a palm up his neck and to the back of his head, pressing him tight against his shoulder even if it leaves the much taller love of his life a bit hunched over. He feels Sherlock tense up, struggle to take a breath. Then, he lets out a strangled sound before racking, gasping, disconsolate sobs take over.

 _It was a close call_ , John can't help thinking. It's only beginning to sink in now how alarming the fact that he can't even remember the past few days is. He could have slipped away without even knowing it himself, and it's the second time Sherlock has had to go through something like this without being able to do much to help. He wasn't there when John got shot in Afghanistan, and he had endured a long journey to Camp Bastion without even a certainty that John was still alive. Now, he had been forced to watch things deteriorate with the knowledge that there were things modern medicine could have offered but which were not within his grasp, even if he had the knowledge necessary to employ them.

Standing on the terrace, not counting minutes or even worrying about the mosquitoes which may well have given him the infection, John holds his husband. He'll stand out here all night if that's what needed to help release everything that's been pushed away and bottled up during the past three days. He knows Sherlock can do that because that's what he'd done in Afghanistan. He had compartmentalised everything, locked his emotions away because he believed they were a frivolity he couldn't afford because John needed him. Lost in his own pain, John hadn't noticed any of it. Lost in his own disappointment and anger, he had nearly let their relationship be destroyed by everything they were both leaving unsaid.

When Sherlock begins to calm down, John still doesn't try to console his partner with words, doesn't attempt to belittle the events of these past days as a quick fix to make him feel better, doesn't try to negate his assessment of how well or badly he has handled things. Right now, Sherlock probably wouldn't believe a word of it. John feels so relieved to just be, to enjoy the embrace that other things are just white noise at the edge of his consciousness. What they both need and what John now has the peace of mind and patience and courage to give—is this. This, just being here, letting it all out. It's staggering how different this feels to how things had been after Afghanistan. This is raw, more honest but easier, somehow.

Eventually, John needs to sit down, so they take over the adirondack couch on the terrace, arms around each other and John's mouth buried in Sherlock's messy curls for quiet words and kisses. Finally, Sherlock pushes himself gently off his chest, presses the heels of his palms on his closed eyelids and wipes his nose on the rolled-up part of his linen dress shirt. It's so sweat-stained and crumpled that it really must have been worn for several days in a row.

"We're both pretty bloody disgusting," John says with a smile. "Sleep now, shower in the morning?"

Sherlock nods and then succumbs to a jaw-splitting yawn. 

 

-o-0-o-0-o-0-o-0-o-0-o-

 

The exhaustion that seems to be a staple of receding Dengue lingers for several weeks. The first days back at work are tough, but John manages by taking plenty of breaks. Louisa is going above and beyond the call of duty with cooking, making sure John has plenty of fruit and appetizingly flavoured water with him at all times. He can manage all the food even though his appetite has suffered—it's Sherlock's mother-henning John most needs to limit. His partner is hard to convince that John isn't going to somehow take a sudden and dramatic downwards turn in his recovery.

Slowly, things get back to normal and John regains his strength, but even after his illness becomes a scary anecdote rather than something complicating their daily life, Sherlock keeps hugging him in bed every night as though he's never intending to let go.

  
 


	10. Lessons Learned

 

> _A deer tethered with a golden chain can escape to the forest to eat grass._  
>  —Malawian proverb  
>    
> 

  
It takes some time for a basic sense of security and calm to return to their life in Malosa. John's strength returns, albeit slowly, and getting back to the work routines they've developed seems to be the best thing for both doctors. He has little success in getting Sherlock to talk about what had happened with the dengue beyond the one evening when relief, stress and fear had finally got the better of him. All John can do is the keep as close an eye on him as Sherlock is now employing in return, and to give his husband some space to process things in his own time and way. Several times a workday, Sherlock seems to be finding excuses to check on him, showing up at the ward or at A&E with some flimsy excuse such as a missing file or needing to fetch a bottle of water. John knows he should trust that Sherlock will talk if he needs to, but so far not even when he wakes up suddenly from a nightmare, disoriented and shaking, will he tell John what it had been that he'd dreamt about. He seems to be trying to drown his anxiety in their work, and John's greatest worry is that his close shave with the viral fever had stirred up Sherlock's memories of what had happened in and after Afghanistan.

Finally, an idea occurs. It's a bit stupid, really, and might be piteously transparent, but it's worth a shot. John remembers how crushing it had been for Sherlock when he hadn't let him help after Afghanistan—how it had decimated what little confidence Sherlock had in his ability to be an equal partner in a romantic relationship. God knows John isn't very good at accepting help, but now that he doesn't really need it, he could easily just bite his tongue and do something for Sherlock. John wants to make him feel the _opposite_ of what he had described during the worst of the dengue: useless and helpless.

So, John starts asking for his opinion on various aspects of his recovery, such as whether his platelet count should still be monitored and whether some of the still-continuing aches and pains should warrant further study. He also asks for small things such as paracetamol and a glass of water after they've gone to bed instead of getting it himself. All this gets him treated to endless and frankly quite boring lectures on all the aspects of dengue infection Sherlock had studied in minute detail because it was all he could do besides ensuring John was receiving the best supportive treatment St Mary's could offer.

Finally, the day arrives when Sherlock gives him an exasperated look, tells him to stop moaning and help fill the shower from a rainwater tank by the shed. This could be Sherlock's way of signalling that he knows what John has been doing all along, but it doesn't matter—it has worked. A side effect of the campaign is that it makes John realise that he still doesn't rely on Sherlock as much as he could. If Sherlock hadn't been in a halo vest and needing a lot of help himself when their relationship hit the rocks regarding Afghanistan, perhaps John would have realised earlier how sternly he had pushed away all of his partner's attempts at helping him recover. He had used the halo vest as an excuse to refuse to address the issue, since he had needed to join forces with others in forcing Sherlock to accept what the halo did to his self-sufficiency.

 _We were both a pair of crocks, trying to fix everything alone_.

Memories of the days after Afghanistan keep bothering John and eventually, he decides to take up the subject over a Sunday dinner.

"There's something I want to say," he tells Sherlock over a meal of deep-fried okra and steamed fish.

Sherlock nearly drops his fork, then grabs his napkin to dab sauce from his lips. He says nothing, just blinks as he scrutinises John's expression.

John reaches out for his hand. "Don't worry, it's nothing bad. Everything's fine," he suddenly feels the need to add, because Sherlock still looks like a deer in headlights. John knows he fears important conversations above all other things because he doesn't feel confident in his ability to communicate the right things. "And, I'm not trying to start some big conversation on this; it's just a thing I want you to know."

 _I'd better just say it; before I do, he's not going to relax_.

He gives Sherlock's hand a squeeze. "I don't remember much about the day you arrived at Bastion, but I remember you walking into my room. I found it so difficult to even try to sort out what I felt then, it was all such a mess, but I do know one thing that I never told you: how safe I felt because you were there. I lashed out at you, wouldn't let you help, pushed you away and I'm so, so sorry for that. I don't know where I'd be, what I'd have done, without you there."

"John." Sherlock's tone carries a warning that John may be about to say things Sherlock doesn't want to hear. There are things John has discussed in detail only with Molly Hooper: the suicidal thoughts, the flashbacks which had, thankfully, only once jeopardised Sherlock's safety.

John raises his palms in supplication. "That's all. That's what I wanted to say. That you're never clueless or useless even when you feel like you are." _Or helpless. Or alone_.

Sherlock turns his wrist so that John's hand now rests on his palm. He frowns at the sight. "Do you––" he starts, then firmly snaps his mouth shut.

"Mm?" John asks.

Sherlock slowly removes his hand, and carefully regains control of his cutlery. "Do you want some bread?" He asks.

 _Sherlockspeak for 'I don't quite know what to do with all that information, but it has been received_ '.

"I would love some," John replies.

 

-o-0-o-0-o-0-o-0-o-0-o-

 

That night, there are no nightmares, though John does wake up to various noteworthy noises created by his husband. It takes his sleep-muddled brain a minute to catch up with what's going on, but after initial worries that Sherlock is being hag-ridden by some horrid memory again, his mind settles on a much nicer deduction: he's having the very _opposite_ or a nightmare. What's going on in Sherlock's dreamscape sounds so nice, in fact, that John tucks his hands underneath the pillow to enjoy the show—maybe there's a chance Sherlock might wake up and demand to turn whatever fantasies his brain has cooked up into reality.

They haven't had sex since the dengue, John realises. For the two of them, it's been a hell of a long dry spell. Not as long as after Afghanistan, but still.

John is too old and too experienced to have wet dreams more often than, say, once a year, and Sherlock is hardly a teenager anymore, either. When having a proper sex dream, he usually just wakes up with a raging hard on, insistent on creating a matching state in John as quickly as possible. Not tonight, though. Slowly, Sherlock's breathing settles, he stops twisting in the sheets, unconsciously trying to find a bit of friction, and flops onto his belly for a serene bout of snoring.

This reminds John of the first time they'd had sex. It had been in the anaesthesia on-call room at King's, into which he had effectively smuggled Sherlock after he'd been drugged and nearly date-raped by a waste-of-breath colleague named Moriarty who is now enjoying a long and not-so-luxurious stay in the cold arms of Her Majesty's Prison Services.

Before the sordid business with Moriarty went down, Sherlock had been angry at John, suspecting that he was having cold feet about being in a relationship with a man. That's why John had chosen that particular morning to take him properly to bed, to show Sherlock that there was no reason to wait, that John wanted him as much as the opposite was true, and that he was ready to commit in all the ways one was supposed to when in love. He had checked that the lock on the door worked, made sure they had condoms and lube. He hadn't necessarily expected the two of them to advance all the way to penetration right away, but then again, he couldn't know what it was that Sherlock wanted out of his first time with, well, _anyone_.

After some kissing and mutual appreciation of what they were already familiar with in each other's bodies after months of sleeping in the same bed and kissing and all that, John had taken a step further by slipping his hand into Sherlock's pants and starting a nice, gentle stroke he had intended as a continuation of foreplay.

For Sherlock, that ended up being the _entire_ play. First time and all, never mind that he was over thirty.

Many other details of their early relationship have slipped out of John's memory, but this one he remembers well: he had just slid his left hand down to gently grip Sherlock's balls just as he began to stroke his shaft a bit faster with his right, flicking his thumb across the tip. He pressed his left middle finger down between the balls, towards the perineum, but before he even had time to look up to see whether this was appreciated, there was a jerk and a strangled gasp, and the fingers of his right hand were soon slick with the warm end results of Sherlock's orgasm.

John was flattered and endeared, whereas Sherlock was embarrassed enough to hide his face under a pillow. There was some determined muttering from underneath that pillow about an acute need for andrological research concerning desensitisation and building of stamina, to which John's reply was to steal his pillow and call him a lovely idiot who had nothing to apologise for. He tried to tell Sherlock that he hadn't had any specific plan in mind, that it was all fine, but the murderous glare he got as a reply made his protestations freeze in his throat.

"Did _you_ have a plan, then?" he asked carefully. Maybe he should have asked this before pants were discarded. _Maybe._

Arms crossed, sitting up, Sherlock told him that, whatever he may or may not have had in mind, his plans did not include coming before they'd got to doing something mutually enjoyable.

"But I did enjoy that just now," John tried to argue.

"Instead of enjoying something _with me_ , you enjoyed it _at my expense_ ," Sherlock countered.

Next, it was John's turn to feel self-conscious, because Sherlock next demanded that John, too, deserved to climax— _Christ on a raft, that was the exact word that wonderful git used_ —and that John might as well do it himself. It wasn't a difficult deduction that Sherlock's preference was based on wanting to avoid any further opportunities at having to demonstrate his inexperience. So, John extended an arm in invitation for him to get closer as he stroked himself to a finish. He'd jerked off in the presence of a partner before, but this was different: never before had he been the subject of such piercing, relentless, laser-focused observation while chasing his pleasure. Sherlock seemed to be memorising every stroke, every twist, every fondle for future reference. At least he closed his eyes when John rolled half on top of him to kiss him just as he came.

The memory is stirring John's arousal, and he briefly even considers waking Sherlock up. But, it's the first night in a long time he has slept with only pleasant dreams for company, so John lets him be. He does scoot close enough to rest his arm across Sherlock's back after stroking his palm down his sweat-glistening spine.

 _In the morning_ , John promises them both. _I'll remind you in the morning how much I've always wanted you_.

 

-o-0-o-0-o-0-o-0-o-0-o-

 

During their last month in Malosa, power-outs plague the area. Today that is particularly unfortunately, since John is trying to sort out things pertaining to their return to London, and Sherlock is waiting for a consultation vie email.

When the electricity finally hums back into action late at night, John gets out of bed and his effort is rewarded by even the fickle AIRTEL internet connection allowing them both to check their emails. Sherlock is ecstatic to find the insider pointers he'd been expecting from Laura Arthur on improvised tibial plates, and John rolls his eyes at a dismissive email from the Malawi Ministry of Health declining his request for funds for a proper anaesthesia workstation. It states that such equipment is to go to the tertiary units at first and, if they have workable hand-me-downs, those may then be moved to Malosa or some other district unit.

"Welcome to Africa," John curses. If the government doesn't ever fix the healthcare infrastructure, Malawi's average life expectancy is hardly going to rise above fifty. He makes a mental note to ask Joseph to stock up on batteries; the man seems to have endless connections in the area, managing to acquire things that other just spread their arms about. All in all, the man has turned out to be an excellent pick for an OR supervisor. He knows everyone, speaks passable English, and, in exchange for Sherlock providing him with a crash course in modern surgery improvised to befit rural Malawi, the man seems to be willing to bend over backwards to keep things running smoothly and to guarantee Sherlock gets what he needs for his operations.

Three weeks of their last four will be spent on holiday; they're due for one once Jens-Erik and Åse return from their annual trip to Norway. Åse's sister has had a baby, so they are staying longer than usual.

They're going to a resort on an island in the middle of Lake Malawi for two weeks, after which they'll head to Kenya for a safari before flying home from Jomo Kenyatta Airport in Nairobi.

The Lake will be a particular treat for Sherlock: it features Malawi's greatest diving, the details of which Sherlock has been enthusiastically talking about for some time, now.

" _Cichlids_ , John," he announces over dinner, leaving John staring blankly. "That's what the rift valley lakes are famed for," he insists

"If you say so," John agrees and shoves a forkful of chicken casserole into his mouth, then spits a piece of bone into his napkin.

"How is it that you can spend this much time in the midst of all this nature and learn _nothing_ about it?"

"I've learned plenty," John protests, "I just don't get a kick off learning the Latin names for every bloody fish in the ocean."

Sherlock huffs indignantly on behalf of all those fish. " _Lake_ fish, John. Essentially, Cichlids are perches."

"Finally, a word I recognise."

"I find it odd that a medical man would suffer from such a profound lack of curiosity towards the natural world."

"I'll be happy just observing _your_ aquatic behaviour instead of a bunch of perches. You look quite fetching in a wetsuit, you know."

Sherlock gives him a half-serious eye roll.

Though he won't be diving, just snorkelling, John is looking forward to what they have referred to as their proper honeymoon. The resort only caters to fourteen guests, and even though it's not a five-star luxury place, it has a certain tropical charm with its stilted bungalows on the turquoise water.

"Just don't swallow any of the water. One tropical infection was enough for this trip."

Lake Malawi, which used to be free of the parasite, has developed a schistosomiasis problem. But only certain areas seem to be affected and where they're going swimming has been safe so far. They will carry with them medication suited for treating it.

"We can't stop doing things just because there's a marginal risk of contracting something. If we only looked at infectious disease risks, we'd never go anywhere," Sherlock argues. "Bilharzia is easily treatable and not life threatening. Not comparable to dengue."

"I know. I just want us both to go home happy and healthy."

  
-o-0-o-0-o-0-o-0-o-

 

After their last workday at St Mary's, Sherlock leans on the doorframe as he waits for John to finish deleting junk mail. "I got a message from Lestrade before the flood wrecked connectivity, by the way. Martha Hudson's husband has died and left her a bunch of real estate she's trying to offload. You weren't answering emails, so she had asked Greg to inquire whether we'd be interested in buying."

"I've been telling you that it's money down the drain, renting in central London instead of buying something in the suburbs."

"She's got a nice little place in central London on offer, actually. With my latest royalties, I think we could manage the asking price. It's slightly smaller than Baxter's place, but the blueprint looks good and the apartment below could perhaps be renovated and connected to it with a spiral staircase. She says that if we're interested, she could keep it off the market until we return."

John has tried to think about going back to London as little as possible before they actually board their flight home. They _will_ go back, and things at King's College will not have changed. Still, John likes to think the two of them have. This whole thing, this leap of faith of taking off to a country few people have even visited, and all the experiences they've had here together—some of which no one at home is likely to even believe.... All of it has been a nice reminder to John that he's not trapped, never was. He's not trapped, as long as he's got someone like Sherlock to remind him of the fact. He hopes Sherlock feels the same—that the world is open to them, and that Sherlock is also free to define who he is and what he wants to do with his life. That he can manage, cope in an alien environment just as well as anyone else. Just as well as John.

"Where is the flat, then?" John asks politely, because Sherlock isn't prone to drop a subject until it has been exhausted.

"Marylebone. Baker Street; the number is 221b if I remember correctly."

"Hmm. We'll think about it. What do you want to do tomorrow?" Their flight out isn't until two days later.

Strangely enough, John doesn't feel exhausted even though they have effectively been on duty for two weeks straight. Today, things have been almost hauntingly quiet at the hospital. There's some sort of a religious festival going on in the neighbouring village. _'Nobody have time to sick_ ,' Joseph had explained to John. His English has improved after spending so much time listening to Sherlock.

"We could pack a lunch, do that hike to the Zokwanira Mtsinje falls Roshin explained about; he says the roads have dried enough that we won't be wading in mud," Sherlock suggests.

"You can drive," John suggests.

With so few police in the area and the roads are mostly quiet, je has been teaching Sherlock to drive—something Sherlock says he had never even considered attempting back home.  

' _Where the hell would you find a teacher, who would take on someone like me_?' Sherlock had asked when John had coaxed forth an explanation. When they first met, Sherlock owned an expensive car which just sat in the garage. Desperate to fit in the prestigious company of his fellow neurosurgeons, he had deduced such a vehicle to be an integral part of trying to blend in. John hadn't known whether to laugh or cry when learned about it. Once they moved in together, the BMW had benefited both: John got to sit behind the wheel, and Sherlock had someone to drive him to work, which he much preferred to taking the Tube or wasting a lot of money on cabs.

There's nothing wrong with Sherlock's hand-eye coordination; he had picked up the practical skills required to physically handle their jeep very quickly. It's just that, in London, the sensory assault of a big city can overwhelm him even as a passenger, and John agrees with his suspicion that not all that many driving instructors have the skillset to deal with an extremely intelligent person intensely challenged by being on the Spectrum.

For John, it has been a delight to witness Sherlock discovering something he thought he'd never do. It breaks his heart over and over again how easily Sherlock dismisses his own abilities and believes every word when someone else questions them. In his medical career, he has fought hard to overcome the prejudices of others and, as a neurosurgeon, he's downright cocky about his own abilities, but in other areas of his life his confidence is often downright non-existent.

John doubts that his husband will ever attempt acquiring a UK driver's licence. Then again, he's learned not to underestimate Sherlock.

"You're better at driving and I'm better at reading the map," Sherlock argues. "Honestly, John, why can't you keep in mind that you have to tell me to turn _before_ we're already passing through an intersection?"

  
-o-0-o-0-o-0-o-0-o-0-o-  
  


After three hours of sweat and toiling up steep cliffs shrouded in mist, they sit down on a boulder to rest their eyes on the clouds filling the deep valleys between mountains like waves rising to crest. Visible in the distance are waterfalls, a still lake with turquoise water, and a herd of zebras grazing on the roadside. John never wants to get used to this, never wants to stop having to inhale sharply when faced with such beauty.

Preserving that wonder means not staying forever. If all this became commonplace—an everyday thing—he doubts it would feel as special.

It's as though Sherlock has read his mind: "I'm ready to go back. I don't _want to_ , not until we've had our holiday, but after. Yes."

John laces fingers with him. Up here, alone, they don't have to worry about curious onlookers. "I've missed not having to worry about, well, _this_ ," he says, giving Sherlock's hand a squeeze.

"Yes, well, it wasn't the problem you thought it would be. Maybe people are more tolerant than those writing Wikipedia articles think."

Sherlock's tone contradicts his words. Maybe he's thinking of tolerance of some other kind, of which John knows he hasn't enjoyed too much in his life.

There's a question John wants to ask, but he's always reticent to bring up Sherlock's past, since it's obviously not something the man enjoys visiting. Asking about it, to John, feels like walking on a cooling lava field; it may look safe but, poke a stick in and it'll be burnt to cinders in the hot, molten core of anger, embarrassment and bitterness just underneath the surface.

"When did you know?" he asks.

"Know what?"

"That you liked men."

"It was more of a question of wondering why the girls were not eliciting the same sort of obsession in me as they did in the other boys. I did, for some time, assume that sexual desire was yet another skill or trait I lacked. I assumed I wouldn't feel such interest for anyone."

"Then what?"

Sherlock withdraws his hand. "What do you mean?"

"What happened?" _Or, more specifically, who_.

"Victor," Sherlock says simply and shifts his gaze away from John.

John breathes out. "Right. Yeah, should have realised."

"I knew him for two years before we even spoke a single word. He caught my attention before I caught his."

John knows his husband better than to expect this to flourish into a full story. Any bit of the past must be coaxed gently out of Sherlock, and the moment chosen carefully. If he's upset or nervous to start with, trying to talk won't work. "I had some… suspicions, you could call them, when I was a teen, that I liked both. But, I had girlfriends and it was fun enough. I don't think I have a preference except when it comes to individuals. When it comes to you, I mean," John hastily adds. "I envy you, actually."

Sherlock leans away slightly to scrutinise him. "Why?"

"It doesn't sound as though it was some big crisis for you, realising you were gay. Doesn't seem like you were hiding it."

"John," Sherlock starts in a disappointingly condescending tone. It's the one he only uses when he seems to have decided John so clueless that it might not be worth the effort to explain. "Being gay was never the worst thing people saw in me. It was a margin note, a foul cherry on top of a rotten cake. Why focus on that, when there were so much more salient things to mould into insults?"

Anger rises in John, gnawing at the pit of his stomach like an animal trying to burrow through. He keeps forgetting that the way he sees Sherlock is not how most people react to him. It's so bloody cruel and unfair what Sherlock has had to endure, and John wishes nothing more than that he could have been there, that Sherlock could have had one friend on his side growing up. He has made it quite clear to John there were none. It seems that eventually, Sherlock began to use his solitude as a shield against those trying to take him down for his intelligence, his social ineptitude, his strange interests, and intransigent habits. Sherlock did eventually find Victor, who introduced him to drugs and didn't return his romantic feelings, but he'd been nearly of age when that happened. It had been a mess, but without that mess it's doubtful Sherlock would have ever applied to study medicine. And, maybe Victor Trevor had at least proven to Sherlock that someone could like him enough to want to be with him, even if just as a friend.

John decides the conversation needs lightening up. They came up here to relax, to be together. _Enough about the past_. "Missing neurosurgery?" he asks.

For the past months, Sherlock has effectively been a general surgeon, and the only operations which have fallen under his actual specialty are simple subdural haematoma evacuations through a burr hole.

"I am. I don't miss the bureaucracy and the expectations of the public, but it seems that, no matter where one practices, things that are not medicine will intervene and distract."

Here, they struggle to acquire even the most basic necessities for the running of a hospital and its operating room. In London, they fight bureaucracy, politics, infrastructural nonsense.

John chuckles. "Once, when I was gassing for an awake craniotomy, someone from the admin floor called to tell me I had to come and address my own mail and put stamps on because the secretaries were all having a training day. I told them I couldn't leave the patient in theatre and asked if they didn't have a single clerk in the whole building who could have done that thing. They said that the union reps have banned cross-departmental redistribution of duties between the secretaries who come through agencies and those employed by the hospital." John shakes his head.

"That illustrates my point: there's always going to be something that trips us up when we're just trying to do our job of looking after patients."

"It all boils down to how we decide to face all that. Since crying or yelling won't usually help, all we can do is laugh about it."

"Mycroft came through with what I asked him. The first shipment should be here in a month." Sherlock had somehow wrenched out of his brother a promise for a series of donations of a basic supply of antibiotics for all secondary hospitals in the country over the next five years.

"That's great."

"I also miss my patients having proper anaesthesia and monitoring," Sherlock adds. "A GA with intramuscular ketamine is a pale ghost of a proper modern balanced GA, and I'd prefer someone to keep an eye on such things as the blood pressure of someone who's just had a big spinal.

Due to a shortage of trained anaesthesia providers, nurses in rural hospitals are often forced to learn to administer spinal blocks and ketamine. There aren't proper post-anaesthesia recovery areas, and even intraoperative monitoring can be severely lacking in equipment and expertise. Single-use spinal needles are cleaned and reused because there aren't enough of them, as John has been horrified to discover.

During the past months, they have also seen illnesses eradicated from Europe by vaccinations such as tetanus, and the devastation brought by HIV as it created a whole generation of orphans. At least the cholera outbreak that wreaked havoc in the Thyolo region never spread to the Zomba district. John had suppressed a shudder when Joseph had shown him a storage room full of plank beds with holes drilled in the middle for the violent diarrhoea that could kill in mere hours if untreated. They'd done a lot of research in preparation for a potential disaster and found some promising results by Bangladesh scientists on zinc supplementation potentially shortening the course of the disease and lessening the dehydration. Strangely enough, while so many other drugs are unavailable due to being most delivered to the tertiary hospitals, zinc turned out to be readily available if they needed it.

"What I will miss in London from here are the sounds," Sherlock says. "I find the nocturnal ones particularly calming; like white noise, or one of those meditative recordings. In London, it's all a cacophony of man-made, ear-piercing clatter and screeching; here, just nature. But, I will trade that for neurosurgery."

John is happy to hear that Sherlock is ready to return to their life in London. The thought of doing so together is what makes the plan feel good for John, too. His own motivation for leaving London for Afghanistan had been to rediscover his motivation and to keep himself from being suspended in a depressing net of commitment, routine, frustrating bureaucracy, and enforced rules. Sherlock's motive for wanting to come here had been to rediscover medicine and to broaden the scope of his own abilities, and John can certainly identify with that. The big difference between this and John's deployment is that they had come here together, instead of John running away from what he didn't even recognise as difficulties in dealing with his own identity in connection to Sherlock's.

Malawi has given them what they came here searching for, and more. They've learned _so_ , so much; perhaps even more than John ever had during his time in the army. As an army doctor he had mostly treated his fellow Westerners and lived in isolation in the camps and compounds. Here, they are a part of the local community. A week ago, John had taught some local teenagers the basics of rugby while Sherlock sat under a tree with his shades on, reading and talking to Louise who was seeking shadow at the same spot as she took a break from hanging up their laundry. Even Sherlock's patient interactions have seemed less wrought with tension here. Being a foreigner gives him a get-out-of-jail-free-card with social faux pas, and the gratitude of the locals seems to constantly amaze and surprise him. During their time here, John has realised that in London, Sherlock does and says a lot of things which are based on the assumption that he will fail and be punished for it, when it comes to interacting with patients and their loved ones. Lately, he has begun to come out of his hard shell a little, to be less wary, less expecting of a blow.

John has decided that they should make an effort to get out of London more, to stop staying so cooped in the city that tends to exhaust Sherlock with its relentless pace, heavy traffic, and sometimes downright oppressive atmosphere. They should go see more of Africa, drive up to Scotland, pop down to France, perhaps see Iceland since it's something that people seem to rave so much about... John finds himself full of ideas for potential future adventures instead of only seeing in front of him a bleak road towards retirement. The thought of returning to the heart of the dregs of the once-global British Empire feels distant and unreal but not like the cul-de-sac it had felt like in Afghanistan. He also isn't torn by guilt over leaving someone behind; it is only in hindsight that he now realises how much that had diminished his ability to enjoy the good bits of his last deployment.

He isn't an army doctor—not anymore. He _is_ a doctor, nothing less and nothing more. He's also a friend and a boss to a group of outstanding professionals at a premier teaching hospital in London. And, he's the husband of a remarkable, amazing, charming, sensitive, handsome and clever man, and being that is not a job or a duty or a lightly made and ill-informed choice—it's his _privilege_.

Sitting on a hilltop looking over the overwhelming beauty, John scoots closer to his husband. When they go back to London, they'll have this—the knowledge that they can do whatever they want, and that they're going to be better at it together than they ever would be alone.

He plants his palms on his knees, the thin black writing that forms his wedding band visible on his ring finger. Just as Sherlock had suggested, they had gone for tattoos to solve the problem of not being able to wear jewellery at work, and getting the work done had been a strangely intimate experience. They'd done it on the morning after the ceremony at a place Sherlock had scouted out beforehand, his selection criteria consisting of a possibility of a double appointment and impeccable infection safety.

 _Sherlock_ , the ring on John's finger says, complete with the date of their wedding.

"I love you, you strange, brilliant thing," he whispers into the dark curls shifting in the wind, and plants a wet kiss on the cheek they are framing, aware that Sherlock will soon rub it off with a frown since the saliva will leave a lingering after-sensation he dislikes.

John doesn't take offence.

Sherlock quietly hums his name and drops his head on John's shoulder, squinting as the sun pierces through the cloud cover.

John has never loved him more than he does here because this place has allowed Sherlock to lose the carefully controlled aloofness he wears like an armour at home, to shed much of his fear of human contact like a winter coat he has no use for in this heat. It remains to be seen if the lessons learned here will last once they return home. John hopes that they will but he refuses to worry about it right now.  
  
  


**Notes for the Chapter:**

> 


	11. Sorely Missed

 

> _Buffaloes are held by ropes, a man by his words._  
>  —Malawian proverb

  
  
"Home sweet home, eh." John's tone is resigned as he turns off the engine in the staff parking garage behind the Bessemer Wing of King's College Hospital. Instead of a jeep drive in the scorching Malawi sun, they are now back to having to battle the oppressive grey London weather and the city's relentless morning traffic for at least an hour every morning to get to work.

"Indeed," Sherlock replies, and puts his coat collars up to shield himself from the biting wind. There's a whisper of snow in the air: heavy cloud cover hangs like an awning above them as they walk to the staff entrance.

"Want to go grab some coffee first?" John asks. They've had an espresso each already, but maybe an extra helping of caffeine might help dissipate the doom and gloom of settling back into old routines. There's no jetlag since the time difference to Malawi is just an hour, but they're still tired from traveling.

"I assume I'm on ward duty, since Alice did not text me otherwise; I should head straight there." Sherlock had asked his recently graduated trainee, who is due to move to South Africa soon for her first Consultant-grade job, to message him if any surgeries were scheduled for this Monday morning so that he could come in on the preceding evening to prepare. They'd landed on Saturday evening, so it had been a relief that John didn't have to drive him to King's on Sunday. They're staying in Mycroft's house in Knightsbridge until they find a new rental or buy a flat. Sherlock has been messaging back and forth with Martha Hudson, the former Director of Operative Services, about the flat she has inherited from her late husband, and they're going to view it two days from now.

They're just about to part ways in the main atrium of the wing, when Greg Lestrade hurries past, briefcase in hand. He skids to a halt when he recognises John and Sherlock. "What are you two doing here?"

"Nice to see you, too," John chuckles. "You didn't remember we were due back today?"

Greg frowns. "No, I did remember, but you're supposed to be at the neuro sim thing this morning."

"What neuro sim thing?" Sherlock demands. "I wasn't informed of this."

"I emailed John on Friday since you tend to ignore what I send you." He consults his watch. "It'll start in ten minutes at Chantler."

"On the Guy's campus?" John asks. "Fuck."

The Chantler Simulation Centre is in Southwark, whereas the King's College main hospital building is in Camberwell's Denmark Hill. It'll take them at least twenty minutes to get there by car, assuming they can find parking. John digs out his phone from his pocket and opens his work email. It takes him some time to find Greg's message—the Trust's spam filters had automatically directed it into the Junk Mail folder.

"You had a good time on your honeymoon, then?" Greg asks.

"Yes, we––" John starts, but Sherlock cuts in.

"Technically, our honeymoon consisted of the last twenty days, of which my favourite part was our sex and scuba week on Lake Malawi," he announces.

Greg's brows hitch up. John closes his eyes and pinches the bridge of his nose, which doesn't escape Sherlock's notice.

"What?" he asks, annoyed. "That's what _you_ called it."

"Not to other people," John sighs.

Greg glances at his watch again. "I've got to run. And so do you. I booked you into today's group because I thought it would be a nice, slow start to coming back. "

Sherlock rolls his eyes. "A _nice start_? Granted, simulations are a sensible way to practice emergency scenarios, but mostly they are tedious, badly scripted and as full of idiots as real situations."

"There's also a quality seminar and teamwork exercises included," Greg adds with a smirk.

"I thought we boarded a flight to London, not to the ninth circle of hell," Sherlock mutters as he hurries after John who's already heading back to their car.  
  


-o-0-o-0-o-0-o-0-o-

  
Thankfully, a hold up on the underground has delayed the start of the sessions , so John and Sherlock manage to slip into the crowd during the delayed start. They pick up the news that most of the simulation exercises of the day have been re-scheduled to a later date; the leader is still stuck on a platform south of Bromley waiting for a train. Among the crowd gathered in the foyer, John finds the Quality instructor, a woman by the name of Ellie Donne, and apologises for being late.

"It's fine; all we've do so far is go through today's shorter schedule. Has Mister Holmes arrived with you?" she asks, shaking John's hand.

On cue, Sherlock strides up to them, a half-eaten Danish in hand. He'd left half his breakfast uneaten, but his incorrigible sweet tooth has struck again.

She offers her hand, which Sherlock regards with his usual disdain. "Shaking hands is a powerful vector for transmission. Your three children may well currently harbour a representative sample of the usual autumn selection of respiratory viruses, so I'll skip."

"How'd you know I have––"

John clears his throat. "So, how long will this take?"

The woman frowns. "This was to be a full-day thing. Weren't you informed? Even though the simulation has been postponed, we’re going ahead with the rest of the content. The Trust has made it mandatory for all members of trauma teams and neurosurgical personnel to attend this course, and instead of the old short simulation session we've added team building and communications modules as well as the annual quality update."

Sherlock stops chewing on his Danish. "You've added _what_?"

"Oh, we've got a lovely day planned for you all. There's role-playing, peer assessment of communications skills and personality traits––"

Sherlock's eyes have narrowed. "No." He begins buttoning up his jacket and abandons his treat on an empty plate on a nearby table.

"Was it something I said…?" the instructor says.

John grabs Sherlock's arm and walks him around the corner.

"I won't stand for this nonsense," Sherlock tells him and tugs his arm out of John's grip. "I won't be humiliated, and my time wasted with some ridiculous _games_ run by some overeager nurse."

"How do you know she's a–– Nevermind. Like Greg said in his email, this is mandatory."

"Hardly grounds for dismissal."

"At least the sims have usually been decent, you said so yourself. We're a big group; it's unlikely they'll put everyone on the spot, especially those who don't want to participate."

Sherlock lets his gaze roam around the foyer. In attendance are a bunch of nursing staff from the neurosurgical OR, half their registrars including Alice who waves her hand to them, three other consulting neurosurgeons and four other neuroanaesthetists.

"Just like Greg said, yeah? A bit of a change in routine, this."

"We've just had six months of a change in our routines. I want to get back to the OR."

"There's nothing for you to do at King's today."

"There's always research."

"Maybe I'd prefer your company for this," John suggests. He grabs a program sheet someone has left on a shelf nearby. "It's just three hours of what she mentioned before the sims start."

"I'm going to regret this," Sherlock says ominously.

They both pivot on their heel when a female voice greets them from behind Sherlock. Alice, wearing a grey cardigan and jeans, has excused herself from the company of the other trainees. She has shadows under her eyes since she may well have been on call, looks composed and content enough.

"Welcome back," she tells them both.

"Thanks," John says.

Sherlock nods. "Alice."

"It's been busy, but King's is still standing. I was just talking to Marie about wanting to hear all about Malawi; I think she's missed you."

"Don't be ridiculous," Sherlock dismisses. "Are my clinics running as they should be?"

During their absence, Alice has effectively been locuming for him—taking over his outpatient clinic and ward duties since she is now a full-fledged Consultant.

"I'm pretty sure everything will be the way you left it."

"That's what I feared," Sherlock says bitterly.

John wonders why this whole training day has him in such a foul mood, and whether it's connected to the fact that after they left their luxurious safari camp for the airport, Sherlock began to get broody and quiet. They had both declared they were ready to get back to their life in London, but John has no trouble believing that there are certain aspects of working at St Mary's that Sherlock will miss. In Malawi, nobody knew about his reputation, his past difficulties or his diagnosis, and they chalked much of his quirks up to him being a white British doctor not well versed in the local way of life. His training earned him reverence that was not questioned the way it is at home by patients who have done a bit too much googling, or colleagues who refuse to overlook his social challenges in lieu of his surgical prowess. For once, Sherlock had been the one to define who he was, to start anew without the baggage he has to drag around in London. After a few months, John had witnessed a new side of him: spontaneous, carefree, less worrying about what others thought of him, less defensive and alienating.

While still in Africa, such worries had seemed distant and mild but now, John desperately hopes that some of the lessons of Malosa will stick.

  
-o-0-o-0-o-0-o-0-o-0-o-

  
"Alright, so. Our transport issues didn't get us off to a good start and some of you joined us during the break, so let's start from the beginning. I'm Ellie Donne, and I worked as a nurse at the A&E of Guy's for fifteen years before doing an MBA specialising in HR management and getting certified as a simulation instructor. We're already done our introductions this morning, but we've got two doctors joining us belatedly." She nods towards John.

They're a group of twelve, seated in a semicircle around her.

"John Watson," John replies, directing his words to her since everyone else knows him already. "Clinical Director of Operative Services and neuroanaesthetist."

"Welcome, John," Ellie replies enthusiastically.

"Hello, I'm John and I'm an anaesthetist," Sherlock whispers mockingly from next to him as though they were at an AA meeting, and John's lip curls up.

"And then I believe we have Mister Holmes, is it?" Ellie asks, and her smile is no longer as bright.

"Sherlock Holmes, Consulting Neurosurgeon."

"I am aware that not all of your work entails dealing with arriving neurotrauma at A&E, but those patients are often moved swiftly to the OR, so one of our scenarios today will include such a handover. But, before we get to the sims, we're going to use our time this morning to see what we could do to help you get to know each other a bit better and to have a look at how to improve emergency communication."

"I believe we're all familiar with the rules. Or, at least those in any sort of a leadership role should be," Sherlock points out.

"The rules?"

"Crisis Resource Management rules. Ten seconds for ten minutes. Closed loop. Personally directed commands. Designate leadership. Agree on roles. Facilitate tactical response by focusing on the big picture. Delegate communication responsibility. Keep commands concise and unequivocal."

"That's excellent!" Ellie coos. "Information is as critical to people in an emergency as food and water."

"A neurosurgical trauma scenario hardly lasts long enough to require watering and feeding of the participants," Sherlock points out.

"True, true; I was speaking metaphorically."

John claps a hand on his knee with a tight smile to shut him up. Sherlock glares at him in response.

"One thing those rules don't take into account is _body language_ ; the ways in which we signal to others how we _really_ feel about the stuff they are telling us. This isn't just about emergencies; the exercises we'll to today should serve you all well in your everyday dealings with co-workers. Unspoken communication is a new module we've added to our team-building package––" she continues her explanation for some time, but John ignores the rest of it to focus on Sherlock, who looks as though he's sucking on a lemon.

"I'm leaving if this turns into some touchy-feely, furniture tower-building and falling into other people's laps thing," he whispers to John between gritted teeth.

John chuckles quietly.

"We'll start with your homework."

Sherlock perks up. "What homework?" he mouths to John, dismayed.

Donne is looking straight at them. "Doctor Lestrade informed me that you two have been abroad, so it would have been difficult for you to do the preparatory work. So, don't worry about it. You will still get feedback from others, even if you didn't get a chance to give it to them. In giving feedback and improving teamwork, we often focus on faults and problems, so we're going to start off today with good things we could learn from each other. Every participant has been asked to give feedback in advance in the other participants. I will now give everyone theirs in an envelope; the comments are anonymous. Please refrain from sharing the contents with others just yet; once everyone has read theirs, we will do a round of asking everyone what thoughts this exercise brought up and what positive things they would like to personally adopt from those they have given feedback on."

When Donne approaches Sherlock, he shakes his head. "No point."

"Excuse me?" Her hand, holding the envelope, hovers in mid-air between them.

"It's going to be empty," Sherlock announces.

She smiles. "I've gone through every one of these to make sure they're properly done.

"So, they've been edited?"

"Only names and other details from which individuals could be identified have been removed. Nothing else has been altered."

"So, it's empty," Sherlock stubbornly argues, sticking his hands in his jacket pockets.

"Thank you, Ellie," John says sunnily and snatches the envelope.

She frowns, then moves on.

"I don't want it," Sherlock says.  He crosses his arms and John chuckles at the downright adolescent petulance emanating from him.

"It's _positive_ feedback," John reminds him.

"Exactly. Whatever is in there, is going to be sarcastic or passive-aggressive or some other form of communication which I would misunderstood, which is exactly what people would want to get back at me, and she is simply too stupid to have noticed."

John makes the decision for him, rips open the envelope, and starts reading, standing up and stepping away before Sherlock can grab the sheet from him.

 _"Doctor Sherlock Holmes is…_ " is the headline, under which participants' answers have been copy-pasted:

_"very good with children_

_not afraid of discussing difficult topics with patients_

_doesn't abandon junior doctors to make decisions alone_

_is a really great neurosurgeon_

_has changed a lot in good ways since he came to King's_

_gives very clear and precise directions to scrub nurses_

_is much funnier than he's aware of_

_if I got a brain tumour he's the surgeon I'd pick"_

John offers the sheet to his husband. "Trust me: you'll want to see these."

Begrudgingly, Sherlock takes it, looking as though he has been returned a test with a lousy grade. He turns slightly away from John to read it, even though John's already seen what's on the page.

As he reads the words on the page, Sherlock's frown deepens. His fingertips are perched on his upper lip, thumb tip on his jaw. He looks confounded, disbelieving.

When most other participants have filed out of the room to fill their coffee mugs before the discussion part, Sherlock is still sitting and staring at his piece of paper.

John sits down next to him, steaming mug in hand.

When Sherlock doesn't start to react to his presence in any way, John waves a hand in front of his face. "Hey?"

Sherlock flinches to life and he fixes his gaze on John. "This isn't right. This is someone else's."

"Well, it mentions Alice, and it mentions us coming back, so it can't really be the wrong sheet."

"But it's–– I don't understand."

"What don't you understand?"

"These are all positive."

"That's what they were told to write—positive things about their co-workers."

"I thought it was going to be empty. Save for, perhaps, a pity-entry from someone like Lestrade."

"Greg's not here, it's not empty, and those people really meant what they wrote."

Sherlock gives him the paper. "It must be sarcasm, then, which is doubly insulting since I can't easily pick up on it."

"No, it's not. I promise you I couldn't find any. Sherlock––you do understand that not everybody hates your guts at King's?"

"Alice, Marie, you, Greg. I'm sure the rest would pop open some champagne if I quit."

"But…" John frowns at the comments on the page. "You're fast, efficient, you don't cut corners when it comes to surgery, and you don't waste anyone's time with vague directions or hemming and hawing. You may not be the easiest to work with, but you don't play games or get passive-aggressive. They're used to you, and unlike you, they're capable of seeing the good things about you. When you got along with people in Malosa, I think you chalked up a bit too much of that to the fact that you were a foreigner and a surgeon. Plenty of my friends have liked you, once they got to know you. Harry likes you, in her own way."

"I don't know what to say."

"That's a first." It actually isn't, not when it comes to dealing with people, but John is both endeared and heartbroken to see his partner so bewildered by the notion that people find good qualities in him.

"Why do you think I married you? Because you can hold a scalpel? No, because I know the real you, and that's a person other people would enjoy meeting, too. And, I think you've let that person push through once in a while during the past few years, especially in Malawi. And I want to see more of that. You may think it's a risk, that you might end up getting hurt, but what did all that defensiveness and pre-emptive aggression bring you? Did you get hurt less by other people? No, I don't think so. It just helped you hide it all."

"You thought that nobody could come up with anything nice," John rephrases. "You're wrong. After Malawi, I'd have assumed that you would accept that not everybody hates you. They never have."

 

-o-0-o-0-o-0-o-0-o-0-o-  
  


As he sips on his third coffee of the morning, John keeps wondering what it is about the feedback that has so thrown Sherlock. It’s not like he hasn’t been shown recently that people care: Louisa had shed tears and patted Sherlock's curls before drawing him in for a bear hug as they were leaving, and Joseph had seemed earnest in his gratitude about all the instruction he had received from the _England surgeon_ , as some of the staff called Sherlock. The Norwegians had spent much more time with them than their duties would have warranted, and Åse and Sherlock had had long discussions about classical music and the local flora and fauna.

By all accounts, Sherlock had made friends out there. On his own, without John paving the way for him. Perhaps his foreignness has smoothed some of the difficulties of communication, but did anything but the end result really matter? John understands why Sherlock would be reluctant to come back—after all, he had wanted the sabbatical to get away from his reputation and the tremendous expectations placed on him as an NHS physician, made worse by the fact that he doesn't communicate in ways that most other doctors do.

"I wish you'd see yourself the way I see you," John had told him on the plane back when he'd been trying to coax Sherlock to talk about why he was in such a sour mood. He must have guessed right that his partner was nervous about coming back to what he sees as a minefield of social interaction. "Because it sure as hell isn't the way you see yourself."

"You're biased," Sherlock had told him, and then proceeded to inform the child sitting behind him who kept kicking his seat precisely what he thought of her mother's parental competence.

"If you were a complete arse, I wouldn't put up with you."

"Incidentally, you've told me that my arse is one of my assets," Sherlock had replied loudly enough to be embarrassing, and the statement had lacked the playful innuendo John would have hoped he could coax out.

"Maybe I am biased, but have you considered how much easier things have gotten for you? Fewer complaints, for example."

"Such high praise, that. I fail marginally less, judging by one parameter. Thank you, husband mine." He had put his noise-cancelling earphones on to block out the sound of the place and closed his eyes, making it clear that he didn't want to continue the conversation.

By the time a taxi had dropped them off at home, Sherlock had been too exhausted to even sulk since he can never sleep on planes. They'd fallen into bed without even taking a shower first.

Looking at Sherlock now, John sees his confusion. "This one's Alice, obviously," he says, pointing at one of the comments. "And, that one's got to be Anderson. It must have been mandatory to put something on everyone's section, otherwise he might have just shut up."

"I don't know who this is. One of the scrub nurses, most likely." Sherlock looks confused, finger tracing one of the comments.

John points at the bottom of the page. "If I had to guess, I'd say that one down there's Marie."

Sherlock hums, rereading the comments.

_"Sherlock is really good with kids_

_Thank god he's coming back, so we don't always have to stay overtime with transsphenoid cases; the other surgeons are so much slower_

_If I had a brain tumour he'd be the surgeon I'd pick, never mind that he's a bit rude_

_He has become a very good teacher_

_He comes to work on time_

_He used to behave really badly but he's improved a lot_

_He never cuts corners when it comes to patient care_

_He is an outstandingly talented neurosurgeon, and he's even started to turn paperwork in on time"_

"That one has to be Greg," John points out. Paperwork has been a constant source of friction between Sherlock and his immediate supervisor.

_"He always knows what to do in an emergency and gives very clear instructions_

_His notes are really thorough_

_If a registrar asks for help he always comes right away and fixes things"_

"They wrote this because they had to. Because the survey wouldn't let them continue on without putting something in," Sherlock mutters.

"Well, they could have put 'no comments' or just a hyphen," John suggests.

_"He's the best neurosurgeon at King's"_

"They haven't defined 'best'," Sherlock protests. "Clearly, some other surgeons are much better at certain aspects of the job."

_"I'm glad he's returning, because we have a good system going at the outpatient clinic. He's effective and knows his field, and it's a privilege to work with him."_

"There's Marie," John says. "At least I think so.

Sherlock is staring at the words, saying nothing. He looks upset.

"Sherlock?" John asks.

"I still don't understand––"

John melts into a smile. "There's nothing to understand, really. That's what they thought when someone asked them to write about you. Simple as that."

Sherlock's hand holding the papers falls. He's blinking, and his other hand creeps up to touch his jacket on top of his collarbone, fingertips rubbing on the fabric seam.

John glances around; no one is paying attention to them. He gently pries the stimming hand off his partner's lapel and gives it a squeeze. "It's alright. It is you they're describing. It _was_ you, even before we left."

Another glance around tells John that the others are delighted by what they have read in their own papers. A few surprised expressions can be seen, but no one is as shocked as the man who has recently become his husband.

"Maybe there is some… Recalibrating to be done," Sherlock finally says after John tugs him back to sit in their seats.

"Recalibrating?"

"I always thought it were the opinions of other I needed to change to get by. To prove things. Lately, perhaps, I have been trying to prove things to myself. According to these––" he thrusts the papers onto John's lap, "––my baseline has not been entirely accurate."

"You've always been your worst critic. In Malawi, you didn't assume the same things would happen as you always assume at home when it comes to interacting with other people. You… relaxed, is maybe the word. And you were fine. You guard yourself so carefully, and that's what people sometimes notice and think you're cold," John explains quietly. "In Malawi, you let yourself be a bit more open, to be more yourself—the one I know and see at home. And it worked."

Sherlock still looks thoughtful. There is no instant changing of habits and thoughts patterns which have been in use for decades.

But, if John can change his, then maybe Sherlock can, too.

"Glad we came back?" John plucks up the courage to ask.

Sherlock bites his lip. "I _have_ missed having proper access to an MRI and CT, having actual hospital beds available for patients, and not needing to be on call twenty-four seven. And, _God yes_ , I have missed neurosurgery."

Ellie Donne then returns to the room and starts explaining things about recognising the strengths and skills of team members. John watches Sherlock carefully fold the paper and put it in his pocket.

  
-o-0-o-0-o-0-o-0-o-  
  
  


At lunch, after being uncharacteristically amicable towards Miss Donne and her exercises, Sherlock scrutinise the comments he'd been given again, as though he still doesn't quite believe they're real.

Alice strides over to join them, urgency in her expression. "Sherlock? I forgot to mention that I promised Philip I'd talk to you when you got back."

Sherlock folds the papers in half and sticks them in his breast packet, expression now wary. "What does he want? An appointment to trade insults?"

"No," Alice laughs. "He's putting together a string quartet for the Christmas party and he's one violinist short."

"It makes sense that I'd be the last person to ask. How did he even know that I play?"

"He may have been lamenting about having such a problem in the coffee room and I said you play. You should have seen his face; it was half hopeful and half like someone had just driven over his dog."

"He doesn't have a dog."

John pats his arm with a grin. "Who else is in this ensemble?"

"Well, it's Philip on the cello––

Sherlock's brows hitch up. " _He_ plays?"

"Yeah, I guess. So, it's him, one of the new Regs from Oncology on viola and Tom's wife on violin; she teaches strings."

"What are they planning on playing, then?"

"Philip says it depends on whether, quote: _'Holmes is actually any good_ '." Alice is laughing. "He did mention some possibilities because he was you were going to ask; I don't remember all the he mentioned since I'm not familiar with that stuff but there was at least Haydn and Schubert."

Alice has heard Sherlock play; they had invited her for dinner once and after dessert, Sherlock had performed a bit. It had been John's suggestion to lessen his partner's anxiety about being able to sustain acceptable small talk and keep their guest entertained.

"Schubert? Well, it can't be "The Death and The Maiden" because even I can tell that would be a faux pas for Christmas."

"You'll have to ask him."

Sherlock rolls his eyes. The conversation seems to have ended, and a man less familiar with Sherlock might interpret his reaction as dismissal, but John can tell from his current expression that he is interested, even if only to prove to Philip Anderson that he is, indeed, _'any good_ '. He never goes to office Christmas parties, but if he literally had a role to play… It might also be a tad bit flattering that he is being asked to do this instead of everyone hoping he'd stay away.

Compared to what he has proven to himself, and everyone else doubting his adaptability and his skills in dealing with people during the past eight months, playing at a Christmas party will be a piece of cake.

 

**–––The End–––**

 

 

**Notes for the Chapter:**

> Thank you all who have read, kudosed, commented or otherwise joined this journey. As always, it warms my heart to see how many friends my doctor boys have. That was fun, wasn't it — taking them out of London for a change? While this particular story ends here, the series sure doesn't. The next part is being written as we speak by yours truly and 7PercentSolution, and it will continue on the themes explored here, and it's time to get to know the rest of the Holmes family better!
> 
> The term "England surgeon" pays homage to legendary British neurosurgeon Henry Marsh; a documentary about him is called _"The English Surgeon"_.


End file.
